Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Recommendations
  1. Nurses promote healthy eating and physical activity throughout the lifecycle beginning at an early age.
  2. Nurses advocate for healthy public policies that include:
    • Monitoring and surveillance data at the population level regarding:
      • Nutrition;
      • Physical activity; and
      • Measures of adiposity including obesity and overweight status.
    • Healthy community design.
    • Health promoting school policies.
    • Legislation to limit advertising directed towards children.
    • Community-wide campaigns.
  3. Nurses promote healthy eating and physical activity at population, community, family, implementing, and evaluating interventions that are:
    • Tailored to the strengths and needs of the client and are:
      • Developmentally appropriate;
      • Culturally and linguistically relevant; and
      • Gender-specific.
    • Affordable and accessible.
    • Focused on behaviour change.
  4. Nurses maximize the effectiveness of their healthy lifestyle interventions through interactions that are of sufficient intensity and duration to effect behaviour change.
  5. Nurses support exclusive breastfeeding for infants until six months of age.
  6. Nurses promote healthy eating using Canada’s Food Guide to Healthy Eating and focus on:
    • Using age-appropriate portion sizes;
    • Emphasizing fruits and vegetables;
    • Limiting sugar containing beverages (e.g., soft drinks and fruit juices);
    • Limiting consumption of energy-dense snack foods high in sugar and fat (e.g., potato chips, French fries, candy); and
    • Breakfast consumption.
  7. Nurses promote healthy eating patterns using interventions with one or more of the following components:
    • Small group activities;
    • Goal setting;
    • Social support;
    • Interactive food-related activities (e.g., cooking, taste-testing); and
    • Family participation.
  8. Nurses promote increased physical activity based on Canada’s Physical Activity Guides for Children and Youth using interventions with one or more of the following components:
    • Behaviour modification.
    • Leisure activity of low intensity that is gradually increased to recommended levels.
    • Sustained, repeated interventions.
  9. Nurses promote a decrease in sedentary activities with emphasis on reducing the amount of time clients spend watching TV, playing video games, and engaging in recreational computer use.
  10. Nurses work with school communities to implement school-based strategies for the prevention of obesity using a multi-component approach including:
    • Integrating healthy eating and physical activity messages into curricula;
    • Advocating for and supporting the implementation of quality daily physical education taught by specialist physical education teachers;
    • Advocating for and supporting the implementation of quality daily physical activity (including vigorous physical activity);
    • Using youth driven approaches with an information and advocacy component;
    • Offering healthy choices in cafeterias and vending machines;
    • Increasing physical activity opportunities at recess and during lunch breaks; and
    • Forming community partnerships and coalitions.
  11. Nurses support a family-centred approach to promote healthy eating and physical activity.
  12. Nurses assess physical growth and development of children and adolescents which includes:
    • Discussing and documenting basic dietary patterns;
    • Discussing and documenting physical activity patterns including sedentary activity (e.g., television and computer time);
    • Identifying individual and family risk factors for childhood obesity;
    • Accurately measuring and recording height and weight;
    • Calculating Body Mass Index (BMI) for children two years of age and older;
    • Plotting BMI for age on appropriate U.S. Centre for Disease Control pediatric growth charts as recommended by Health Canada; and
    • Monitoring changes in BMI, dietary and physical activity patterns over time and noting important variations.
  13. Nurses assist clients to access community resources and opportunities to engage in healthy eating and physical activity through:
    • Direct referral of clients to community resources;
    • Dissemination of information about available community resources; and
    • Promotion of low and no cost physical activity options (e.g., hiking, walking, active commuting, subsidized programs).
  14. Nurses are aware of, refer to, and collaborate with appropriate allied health providers based on findings from nursing assessment.

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