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.