Registed Nurses' Association of Ontario

Implementation Resources


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The Ontario Long-Term Care Homes (LTCH) Act, 2007 requires all LTC homes to have a program to minimize restraints. The rationale cited for not becoming restraint-free are: a) falls rate will rise, b) understaffing, and c) family members who insist on use. Research demonstrates more serious injury and increased mortality rates with restraint use (Cleary & Scott, 2015).

The annual direct health-care costs are estimated to be CAD $2 billion due to falls, with older adults accounting for nearly half of these costs. In 2012, the average cost for a serious injurious fall was estimated to be CAD $31,000  when compared to a patient with no falls treated for similar diagnosis. This reflected direct and indirect in-patient costs of 34 days in the hospital with nursing care and excluded physician billing.

In 2010, the global economic impact of dental diseases amounted to US$442 billion. Across OECD countries, 5% (average) of total health expenditures originate from treatment of oral diseases. Recent findings suggest oral diseases account for productivity losses of over $1 billion per year in Canada alone.1 Improvements in oral health would result in substantial economic benefits by reducing treatment costs and by decreasing productivity losses in the labour market.

The aim of this Evidence Booster is to examine the quality of partnerships with persons and families experiencing care through implementation of the RNAO BPG Client Centred Care (2006) and Person- and Family- Centred Care (2015), in one Ontario long-term care (LTC) and one Ontario hospital Best Practice Spotlight Organization® (BPSO®).

The purpose of the Best Practice Guideline Implementation to Reduce Falls in Older Adults is to increase all nurses' confidence, knowledge, skills, and abilities in the identification of older adults within health-care facilities at risk for falling and to define interventions for the prevention of falling.