In Kathleen Dracup and Christopher W. Bryan-Brown’s editorial titled “Evidence-Based Practice Is Wonderful … Sort Of ” (July 2006: 356–358), they reflect that changing hospital culture is difficult. They explain that nurses and physicians currently are aware of evidence-based guidelines and that following these guidelines improves patients’ outcomes. I agree that most critical care physicians in a teaching hospital environment recognize and use current evidence-based practice, but I must disagree that most critical care nurses are aware of evidence-based practice.

In fact, some critical care nurses and most critical care step-down nurses are not aware of current guidelines for specific diseases such as the guidelines for treatment of atrial fibrillation by the American College of Cardiologists (ACC) and the American Heart Association (AHA). I know because I have asked critical care nurses in the step-down unit what they think...

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