Mediator effects of cognitive load on the relationship between task complexity and guideline adherence among clinical nurses: a cross-sectional survey of nurses in China.

BACKGROUND

Suboptimal adherence to guidelines is a common phenomenon in clinical settings. Studies regarding the complexity of tasks, cognitive load, and adherence to guidelines among clinical nurses are noteworthy, but limited.

PURPOSE

To investigate whether cognitive load mediates the association between task complexity and guideline adherence in clinical nurses.

METHODS

In total, 580 clinical nurses from 8 tertiary hospitals were included in the cross-sectional survey. A self-reported survey included guideline adherence, task complexity, and cognitive load. We conducted correlation and multiple linear regression analysis and performed a mediation effect analysis using PROCESS with 5000 resamples.

RESULTS

The linear regression showed that task complexity significantly predicted intrinsic cognitive load (  = 0.322,  < 0.001), intrinsic cognitive load significantly predicted guideline adherence (  = -0.113,  < 0.001), and task complexity had a direct impact on guideline adherence (' = 0.126,  < 0.001). Both intrinsic cognitive load (effect size = -0.037, 95%CI: -0.061, -0.019) and germane cognitive load (effect size = 0.180, 95%CI: -0.269, -0.171) played a partial mediating effect between task complexity and guideline adherence among nurses, contributing to 53.16% of the overall effect.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Nursing administrators should prioritise the cognitive load for clinical nurses when allocating intricate assignments.