Practicing ICU nurses in this survey were often not adhering to the latest evidence-based practice and therefore need to be educated and encouraged to do so in order to improve patient care.

This study weakly supports the association between structural empowerment and moral distress. It also provides further evidence to the theory of structural empowerment as characterized in the critical care environment. Further studies are indicated to determine what other factors might be associated with moral distress.

More measures must be taken to prevent bullying. Nurses must be educated to accept only a zero tolerance to bullying and to report bullying when confronted by bullying.

This national effort to improve EBP did reap some rewards; however, other knowledge translation strategies should be used to further improve clinical practice.

No abstract