Nurses in Long Term Care (LTC) struggle with increasingly complex resident care needs, resource constraints and challenging workloads, resulting in high degrees of moral distress. Nurses report that most of their work is consumed by the administration of medications and treatments to residents with a growing level of acuity and complexity, leaving little time for ongoing assessment and updating resident care plans. This study involved a survey of Registered Practical Nurses (RPNs) and Registered Nurses (RNs) in LTC homes located in five Local Health Integrated Networks in Ontario. The aim of the study was to determine the enablers and barriers to optimizing nursing knowledge in the provision of resident care and the impact on nurse outcomes (e.g., moral distress and job satisfaction) and resident outcomes (e.g. falls, pressure ulcers, restraint use, and changes in physical functioning).