Registered Nurses' Association of Ontario

Summary of Practice Recommendations



Type of Evidence

Patient Decision-Making Needs


Nurses know the common decisions faced by an adult with Chronic Kidney Disease (CKD).


Nursing Actions:

  • Nurses identify the decision the patient is facing at a particular point in time


Nurses screen the patient for decisional conflict at initial  contact and as the patient’s situation and condition changes.


Nursing Actions:

  • Nurses screen for decisional conflict


Nurses determine the source of patient’s decisional conflict.


Nursing Actions:

  • Nurses assess the patient’s knowledge and expectations about the options
  • Nurses assess and discuss the availability  of resources
  • Nurses objectively measure the patient’s confidence and ability for making decisions and self-managing their CKD
  • Nurses assist the patient to clarify his/her values
  • Nurses clarify the patient’s  preferred role in decision making and who else the patient wants to involve in the decision-making process

Decision Support Interventions


Nurses understand the difference between providing patient education and decision support.


Nursing Actions:

  • Nurses describe patient education
  • Nurses describe the additional elements involved with decision support


Nurses use patient decision aids and other tools to provide decision support.


Nursing Actions:

  • Nurses remain neutral when supporting the patient in the decision-making process
  • Nurse use validated tools to provide decision support
  • Nurses help the patient to build confidence in participation in decision making
  • Nurses meet the patient’s knowledge needs
  • Nurses help the patient clarify his/her values
  • Nurses help the patient to identify and mobilize resources
  • Nurses help the patient to communicate with others during the decision-making process
  • Nurses obtain commitment from the patient for the next decision-making step(s)




Chronic Disease
Decision Support for Adults Living with Chronic Kidney Disease
Practice Recommendations