Purpose <p>Nurses need to provide evidence-based care to alleviate symptoms related to cancer chemotherapy. This study sought to clarify the actual implementation of evidence-based nursing practice related to chemotherapy-induced adverse reactions and its challenges.</p> Methods <p>A web-based self‐administered questionnaire survey was conducted among nurses engaged in cancer chemotherapy at nationwide designated cancer hospitals. The survey investigated the implementation of evidence-based nursing practices for three symptoms, namely, skin toxicities, peripheral neuropathy, and fatigue, with reference to the Consolidated Framework for Implementation Research.</p> Results <p>In total, 503 nurses from 205 facilities responded to the survey. Over 90% of the nurses practiced preventive moisturizing, patient education for skin toxicities, and assessment of these signs and symptoms. However, only 69% practiced self-monitoring education for peripheral neuropathy, while only 51% practiced psychological education for fatigue. The relevant factors for these practices were their perception of the importance of evidence-based practices, their habit of searching for evidence, presence of a system for searching literature and learning opportunities in the facilities, and their perception that nurses were focusing on evidence-based practice at their own facilities.</p> Conclusions <p>Some care practices that could be reasonably implemented based on evidence were insufficiently performed, highlighting the importance of reviewing daily practices. Factors associated with care practices were access to knowledge and information and learning climate, besides the individual’s stage of behavioral change. Apart from educating individual nurses, efforts should be directed toward systematically creating an environment that facilitates the acquisition of evidence and establishing a culture of implementation.</p>