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重症监护护士对国民保健制度知识和技能框架的理解。一种解释性现象学分析。

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

机构信息

High Dependency Unit, Victoria Infirmary, Glasgow, UK.

出版信息

Nurs Crit Care. 2013 Jan-Feb;18(1):23-31. doi: 10.1111/j.1478-5153.2012.00524.x. Epub 2012 Aug 31.

DOI:10.1111/j.1478-5153.2012.00524.x
PMID:23289554
Abstract

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.

摘要

目的

本小规模研究旨在探讨重症监护护士对国民保健服务(NHS)知识和技能框架(KSF)的理解与其面临的挑战之间的关系,以及他们的护理角色。

背景

NHS KSF 是重症监护护士专业发展的核心,支持英国医疗保健的有效提供。KSF 于 2004 年实施,但似乎缺乏参与,经常出现挑战。

设计

本定性研究采用解释现象学分析框架。

方法

使用半结构式访谈从五名重症监护护士中收集数据,对访谈内容进行转录以供分析。

结果

确定了两个上级主题,即“参与”和“理论与实践差距”。六个子主题进一步解释了上级主题,分别是“流畅度”、“透明度”、“自我评估”、“为谁实现”、“反思”和“护理角色”。重症监护护士对 KSF 表现出多层次的理解。确定的挑战主要涉及复杂的语言、不明确的过程以及使用反思和自我评估技能。

结论

发现了两个理论与实践之间的差距。重症监护护士理解 KSF 的原则,但要么没有应用,要么没有意识到他们应用了这些原则。他们难以将 KSF 与重症监护实践联系起来,并且觉得它没有捕捉到他们在重症监护中的护理角色的“本质”。

临床实践相关性

建议将 KSF 嵌入重症监护实践中,采用教育方法,并采取灵活的 KSF 方法,以支持重症监护护士的发展和护理提供。

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