Abstract: Objective: To explore the relationship among task complexity, cognitive load, and guideline adherence of ICU nurses, and the mediating effects of cognitive load on perceived task complexity and guideline adherence of ICU nurses, to assist nursing managers in rational human resource allocation. Methods: A convenience sampling method was used to recruit 213 ICU nurses from three tertiary Grade A hospitals in Beijing from October 2023 to March 2024. The Chinese version of the Task Complexity Scale, the Cognitive Load Measurement Scale, and the Guideline Adherence Scale were used for data collection. Correlation analysis, multiple regression analysis, and mediating effect analysis were conducted. Results: ICU nurses' perceived task complexity were positively correlated with guideline adherence scores (r=0.561, P<0.01), and germane cognitive load was positively correlated with guideline adherence scores (r=0.823, P<0.01). Multiple linear regression results showed that perceived task complexity (β=0.227, P<0.001) and germane cognitive load (β=0.717, P<0.001) were both positive predictors of guideline adherence scores. The bootstrap test indicated that the mediating effects of germane cognitive load between task complexity and guideline adherence among ICU nurses was 0.215 (95%CI:0.148-0.288), accounting for 59.55% of the total effects. Conclusion: Germane cognitive load plays a partial mediating role between task complexity and guideline adherence. Nursing administrators should actively implement intervention strategies based on the factors influencing the guideline adherence of ICU nurses.

Key words: Intensive Care Unit nurse; adherence to guidelines; task complexity; cognitive load; mediating effect