The Nursing Process (NP) and the Systematization of Nursing Care (SNC) are essential to ensure high-quality, personalized, and evidence-based nursing care, especially in high-complexity settings such as Intensive Care Units (ICUs). Objetive: to analyze the main challenges and strategies in the implementation of the Nursing Process in ICUs. Method: To achieve this, an integrative literature review was conducted, following the PRISMA checklist, with articles published between 2014 and 2024, available in the databases Virtual Health Library, SciELO, and CAPES. The descriptors used were: "nursing process," "nursing care," and "intensive care units." Original and review articles addressing the topic in ICUs were included, excluding duplicate articles or those unrelated to the ICU setting. Results: The results indicated that the main challenges include a lack of theoretical and practical knowledge among nurses, work overload, and inadequate institutional resources, compromising the quality of care and patient safety. On the other hand, promising strategies, such as continuous training, the use of information technology, and the introduction of NP in academic training, were shown to be effective in improving adherence to the process. Conclusion: It is concluded that the implementation of NP and SNC in ICUs faces significant challenges, but these can be overcome with appropriate strategies, such as revising nursing curricula and developing institutional policies that encourage the consistent application of these practices, contributing to improved clinical outcomes and patient safety.
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