Abstract：
Greater evaluations are needed to identify barriers or facilitators in nurses\' guidelines adherence. The current review aims to explore extrinsic and intrinsic factors impacting nurses\' compliance.
Mixed-method systematic review with a convergent approach, following the PRISMA checklist and the JBI Mixed Methods Review Methodological Guidance was conducted. MEDLINE, Embase, CINAHL were systematically searched, to find studies published between 2010 and 2021, including qualitative, quantitative or mixed-methods articles.
Sixty studies were included, and the major findings were analysed by aggregating them in two main themes: intrinsic and extrinsic factors. The intrinsic factors were: a) knowledge and skills; b) attitudes of health personnel; c) sense of belonging towards guidelines. The extrinsic factors were: a) organizational and environmental factors; b) workload; c) guidelines structure; d) patients and caregivers\' attitude.
The included studies report lack of resources, among environmental factors, as the main barrier perceived. Nurses, who are at the forefront in addressing the direct application of knowledge and skills to ensure patient safety, have a higher perception of this kind of barriers than other healthcare personnel. Potential facilitators emerged in the review are positive feedback and reinforcements at the workplace, either from the members of the team or from the leaders. Moreover, the level of active participation of the patient and caregiver could have a positive impact on nurses\' guidelines adherence. Guidelines implementation remains a complex process, resulting in a strong recommendation to support health policymakers and nursing leaders in implementing continuing education programs.
Mixed-method systematic review with a convergent approach, following the PRISMA checklist and the JBI Mixed Methods Review Methodological Guidance was conducted. MEDLINE, Embase, CINAHL were systematically searched, to find studies published between 2010 and 2021, including qualitative, quantitative or mixed-methods articles.
Sixty studies were included, and the major findings were analysed by aggregating them in two main themes: intrinsic and extrinsic factors. The intrinsic factors were: a) knowledge and skills; b) attitudes of health personnel; c) sense of belonging towards guidelines. The extrinsic factors were: a) organizational and environmental factors; b) workload; c) guidelines structure; d) patients and caregivers\' attitude.
The included studies report lack of resources, among environmental factors, as the main barrier perceived. Nurses, who are at the forefront in addressing the direct application of knowledge and skills to ensure patient safety, have a higher perception of this kind of barriers than other healthcare personnel. Potential facilitators emerged in the review are positive feedback and reinforcements at the workplace, either from the members of the team or from the leaders. Moreover, the level of active participation of the patient and caregiver could have a positive impact on nurses\' guidelines adherence. Guidelines implementation remains a complex process, resulting in a strong recommendation to support health policymakers and nursing leaders in implementing continuing education programs.
摘要：
需要进行更大的评估，以确定护士指南依从性中的障碍或促进者。本综述旨在探讨影响护士依从性的外在和内在因素。
采用融合方法的混合方法系统综述，遵循PRISMA检查表和JBI混合方法审查方法学指南。MEDLINE,Embase,CINAHL进行了系统搜索，寻找2010年至2021年发表的研究，包括定性，定量或混合方法文章。
纳入了60项研究，并通过将主要发现汇总在两个主要主题上来分析：内在因素和外在因素。内在因素是：a）知识和技能；b）卫生人员的态度；c）对准则的归属感。外在因素是：a）组织和环境因素；b）工作量；c）指南结构；d）患者和护理人员的态度。
纳入的研究报告缺乏资源，在环境因素中，作为感知的主要障碍。护士,他们在解决直接应用知识和技能以确保患者安全方面处于最前沿，比其他医护人员对这种障碍有更高的认识。审查中出现的潜在促进者是工作场所的积极反馈和加强，无论是团队成员还是领导者。此外，患者和护理人员的积极参与水平可能对护士指南的依从性产生积极影响.准则的实施仍然是一个复杂的过程，因此强烈建议支持卫生政策制定者和护理领导者实施继续教育计划。
采用融合方法的混合方法系统综述，遵循PRISMA检查表和JBI混合方法审查方法学指南。MEDLINE,Embase,CINAHL进行了系统搜索，寻找2010年至2021年发表的研究，包括定性，定量或混合方法文章。
纳入了60项研究，并通过将主要发现汇总在两个主要主题上来分析：内在因素和外在因素。内在因素是：a）知识和技能；b）卫生人员的态度；c）对准则的归属感。外在因素是：a）组织和环境因素；b）工作量；c）指南结构；d）患者和护理人员的态度。
纳入的研究报告缺乏资源，在环境因素中，作为感知的主要障碍。护士,他们在解决直接应用知识和技能以确保患者安全方面处于最前沿，比其他医护人员对这种障碍有更高的认识。审查中出现的潜在促进者是工作场所的积极反馈和加强，无论是团队成员还是领导者。此外，患者和护理人员的积极参与水平可能对护士指南的依从性产生积极影响.准则的实施仍然是一个复杂的过程，因此强烈建议支持卫生政策制定者和护理领导者实施继续教育计划。
