The nurses who work in an intensive care unit are determined to implement evidence-based practice into the care of the patients on their unit. The nurse manager would monitor for a decrease in this determination in which situation? Standard Text: Select all that apply

Question

1. An influenza epidemic has increased admissions to the intensive care unit by 30% over the last month.
2. A rumor has surfaced that participation in evidence-based practice research will be a criteria on nurses' annual evaluation.
3. The hospital has implemented new electronic health record software.
4. In the last week, three patients have died unexpectedly.
5. The summer vacation schedule has required the use of an increased number of agency nurses over the last month.

Answer 1

1, 3, 4, 5
Rationale 1: An increase in workload, as would be caused by 30% more admission, may make nurses fall back into using familiar interventions that are not particularly evidence based.
Rationale 2: Having an EBP criterion on the annual evaluation should encourage the nurses to continue to participate.
Rationale 3: Anything that increases the nurses' workload or stress may adversely impact desire to participate in EBP.
Rationale 4: Unexpected patient deaths can make nurses doubt their current practice. If EBP has been used as part of these patient's care, nurses may doubt the wisdom of the interventions.
Rationale 5: Increased use of agency nurses may increase the stress level of nurses employed by the facility. The agency nurses may also not be cognizant of the unit nurses' commitment to EBP which would increase stress.
Global Rationale: