Challenges of autonomy in nursing: an integrative review

Increased the responsibilities of the professional nurses need to autonomy in their activities. Achievement autonomy in nursing has facing with problems and challenges. The aim of this study was explored the current challenges in the field of autonomy. An integrative review of evidences based on Broome protocol (2000) conducted in three stage، literature search، data evaluation and data analysis. Databases of SID، Magiran، IranMedex، Irandoc، MEDLINE، EMBACE، EBSCO and CINAHL were searched by key words of professional autonomy and nursing. Of 1230 full text and abstract، finally، 29 articles were chosen based on inclusion criteria: professional autonomy was in text، original research and review studies، internal and outside the country reliable articles، study focuses’ on clinical and professional challenges and access to full text article without any time limit. And exclusion criteria were studies in the field of philosophy، research، education and instrumentation nursing autonomy، and abstract of studies. For data analysis، data extracted from primary sources، after comparing one by one، data integrated، ordered، categorized and summarized. The main challenges were unclear of autonomy definition، use of inappropriate tools for measuring autonomy، absence of a theory related nursing autonomy، poor students education and emphasis on traditional teaching by teachers، failure in collaboration and teamwork، lack of management support and inappropriate management structures، also، hospital size and its impact on organizational structure and the level of nurses’ power. Offered strategies should be ordered to control these challenges. Conducting the extensive researches on reliable tools for accurate diagnosis of challenges in current context and the qualitative research for concept definition and properties are highly effective.