Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Patient Decision – Making Needs

1.0 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

2.0 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 (using the SURE tool, refer to sample tools)

3.0 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