Agenda for Change– The largest ever planned change

Critical Care nurses' understanding of the NHS knowledge and skills framework. An interpretative phenomenological analysis

AIMS

This small-scale research study aimed to explore Critical Care nurses' understanding of the National Health Service (NHS) Knowledge and Skills Framework (KSF) in relationship to its challenges and their nursing role.

BACKGROUND

The NHS KSF is central to the professional development of nurses in Critical Care and supports the effective delivery of health care in the UK. KSF was implemented in 2004 yet engagement seems lacking with challenges often identified.

DESIGN

This qualitative study adopted an Interpretative Phenomenological Analysis framework.

METHOD

Data were collected from five Critical Care nurses using semi-structured interviews that were transcribed for analysis.

RESULTS

Two super-ordinate themes of 'engagement' and 'theory-practice gap' were identified. Six subthemes of 'fluency', 'transparency', 'self-assessment', 'achieving for whom', 'reflection' and 'the nursing role' further explained the super-ordinate themes. Critical Care nurses demonstrated layers of understanding about KSF. Challenges identified were primarily concerned with complex language, an unclear process and the use of reflective and self-assessment skills.

CONCLUSIONS

Two theory-practice gaps were found. Critical Care nurses understood the principles of KSF but they either did not apply or did not realize they applied these principles. They struggled to relate KSF to Critical Care practice and felt it did not capture the 'essence' of their nursing role in Critical Care.

RELEVANCE TO CLINICAL PRACTICE

Recommendations were made for embedding KSF into Critical Care practice, using education and taking a flexible approach to KSF to support the development and care delivery of Critical Care nurses.

Job evaluation for clinical nursing jobs by implementing the NHS JE system

AIM

The purpose of this paper was to evaluate locally all the clinical nursing jobs implementing the NHS JE system in four hospitals.

BACKGROUND

The NHS JE was developed by the Department of Health in the UK in 2003-2004.

METHODS

A job analysis questionnaire was designed to gather current job descriptions. It was distributed to each of 158 clinical nurses and supervisor nurses in 31 variety clinics at four hospitals in one city. The questionnaires were analysed to evaluate locally all the identified 94 nursing jobs.

RESULTS

Fourteen of 19 nursing jobs in the medical and surgical clinics can be matched to the nurse national job in the NHS JE system.

CONCLUSIONS

The results indicated that two new nursing jobs titled nurse B and nurse advanced B should be added to the list of national nursing jobs in the NHS JE system.

A revision of a job evaluation system

AIMS

This paper reports a revision of the United Kingdom's National Health Service Job Evaluation System and tests the revised system in eight clinical nursing management jobs in four Turkish hospitals.

BACKGROUND

A job evaluation system was developed in the United Kingdom in 2003-2004. Most studies have focused on how the whole system will be implemented in a health organization. No study investigating proficiency of the system in terms of factors and their level definitions was found.

METHODS

The factors Knowledge, Training and experience and Working conditions were divided into five factors: Knowledge, Experience, Education, Environmental conditions and Hazards. To test the revised system, all the nursing management jobs in four hospitals were evaluated using a factor-based questionnaire including nurses' demographic information and 19 variables. The questionnaire was distributed to 57 supervisor nurses in 31 clinics at four hospitals in one Turkish city in 2005. All the questionnaires were analysed to evaluate the jobs.

RESULTS

The job scores change depending on clinical conditions. Although the score range in the National Health Service Job Evaluation system has been determined as 405-465 points (band VI) for Nurse team leader and 469-536 points (band VII) for Nurse team manager jobs, the job scores in the present study were 363 (band V) - 557 points (band VIIIa) and 379 (band V) - 586 points (band VIIIa) respectively.

CONCLUSION

Although this exploratory study was limited to four hospitals in one city in Turkey, the results indicated that two new jobs would be identified in the National Health Service system to match the jobs in the intensive care and emergency units.