Introduction: While clinical practice guidelines often guide nurses and allied health professionals in how to maintain quality of care vis-à-vis physical needs, how to arrange for patients’ participation is more seldom established.The OPTION-trial tested and evaluated an intervention facilitating the adoption of clinical practice guidelines for bladder-monitoring in hospitals. We also investigated whether this impacted on the patients’ preferences for and experiences of being involved in their care in general, and bladder care in particular. Aim: To describe the impact on patient participation of an intervention facilitating implementation of evidence-based clinical practice nursing guidelines in orthopaedic care. Methods: This study represents a secondary analysis of the OPTION outcomes in 17 orthopaedic units in Sweden. Patients’ preferences for and experiences of participation was measured with the 4Ps questionnaire, and interviews with nursing and rehabilitation staff in the intervention units were conducted. Both statistical and qualitative analyses were performed. Results: We found no clear effects on preference-based participation. The intervention may have had some impact on patients’ opportunities to engage in such ways and to the extent they favoured: post intervention and at the 1 year follow up, patients were more likely to having been listened to in accord with their preferences. Staff described that they had achieved more knowledge regarding bladder care and were more prone to adhere to the clinical practice guidelines as well as to engage patients in the bladder-care following the intervention. Still, no such effect was detected for the patients’ preferences for learning about symptoms, and/or engaging in self-care. Conclusion: Implementation of clinical practice guidelines does not per se boost the conditions for preference-based patient participation. While it can have a positive impact on the staffs’ willingness to engage patients, the findings indicate a further need to emphasise a recognition of patients’ resources in nursing guidelines.