Best practice guidelines, although a recent phenomenon, have become a global movement in nursing. Scholars, practitioners, healthcare organizations, governments and the nursing associations have a unique opportunity to enhance quality and demonstrate joint accountability to patients, the healthcare system and the public as a whole. This article offers insight into the Registered Nurses Association of Ontario (RNAO) Nursing Best Practice Guidelines Project. Funded as a multi-year project by the Ministry of Health and Long-Term Care in 1999, the RNAO project is leading nursing's best practice guideline movement in Canada and reaching others abroad.