A 4-year curriculum project (2004-2008) to integrate patient decision support into an existing curriculum was guided by the Knowledge-to-Action process model. The purpose of this project was to integrate a patient decision support theoretical framework and associated evidence-based resources throughout a four-year baccalaureate nursing curriculum. Interventions designed to adapt knowledge to local context and overcome barriers to knowledge use included faculty workshop to increase awareness, instructional resources designed for courses and core content, curricular blueprint of key threads to be included within courses, shared resources on the school of nursing internal website, and development of decision support resources in French. Curricular change and sustained use of knowledge was evidenced by repeated use of guest lecturers, assignments, and problem-based scenarios in courses, and students' evaluations on the tutorial and assignments.