National Competency Framework for Registered Nurse

in Adult Critical Care

2

What was the problem?

• Changes to educational regulation and centralisation– Demise of the English National Board– Emergence of various critical care programmes– Different standards in relation to access, content, outcomes and

accreditation

• Units concerns– Issues associated with workforce transferability– Programmes not fit for purpose– Value for money

National Concerns

Framework

Step 1

Step 2Step 3

Competence

Progression Pathways

Newly Registered

Initial assessment & development plan Preceptorship programme InductionSupernumerary period (minimum of 6 weeks)Sign off supernumerary competencies Remaining Step 1 competencies 3 monthly on-going assessment reviews

New to Critical Care (with registered experience)

Initial assessment & development plan InductionSupernumerary period (minimum of 6 weeks)Sign off supernumerary competencies Remaining Step 1 competencies 3 monthly on-going assessment reviews

Transferred from other Critical Care Unit

Initial assessment & development plan (to include evidence of previous competency attainment)InductionSupernumerary period (negotiated locally)Step document appropriate to experience 3 monthly on-going assessment reviews

Process for implementation

• Identify a ‘Lead’ for implementation– Ensure collaborative approach for multi-site

implementation • Ensure approach is adopted & supported by the senior team • Identify lead assessor & mentor pool • Set realistic implementation plans & timeframes • Be clear about which staff are completing the framework (i.e.

new starter, existing staff)

Principles of implementation-Step 1

• Allocation of clinical mentor/assessor• Complete learning contract & initial assessment &

development plan • Highlighted competencies in Step 1 need to be completed

during supernumerary period (minimum 6 weeks)• Competencies should be completed within the recommended

timeframe (approx. 12 months) • Step 1 needs to be completed before commencing a post

registration critical care award

Principles of implementation-Step 2 & 3National Standards for Critical Care Nurse Education (2012)

60 Credits Level 6 or level 7

Core CurriculumAssessments- exams, vivas

Successful completion of academic programme

National Competency Framework for Critical Care Nurses (2015)

Steps 2 & 3 CompetenciesDelivered by expert Critical Care

Work based standardised clinical assessment

Successful completion of academic competencies

Validated and transferable Critical Care Award

Adding Value • Motivated & confident staff

– Supportive structured assessment• Reduced skill variations

– Established staff • Provides evidence for NMC revalidation • Informs performance reviews • Contributes to workforce planning

– Skill mix– Establishment – Recruitment (transferable skill set with evidence)– Retention

• Supports training needs analysis• Provides improved governance process• Creates National consistency & currency

What’s new 2015?• Step 1

– Introduction booklet incorporated– Supernumerary competencies identified– Supernumerary sign off

• Step 2 & 3– Removing repetition (aligning knowledge & skill assessment) – Inter & intra hospital transfer relocated to Step 1 & 2

• Across all steps– Reviewed to reflect current evidence & national guidance – More generic neurological section – Practical renal replacement therapy competencies are unit specific – Inclusion of NMC Revalidation documentation – Inclusion of signature record

Benefits• Patients

– Delivery of safe, consistent quality care regardless of location • Learner

– Structured framework for development – Nationally transferable

• Unit– Assurance of skill set & competence – Selection for courses

• Organisation– Quality assurance & benchmarking

• HEI’s – Nationally transferable award– Improved collaboration – Assurance that programme is clinically credible

Vision for the future

• Guidance for a standard induction • Step 4-senior critical care nurses • Specialist additions-‘Bolt-on’– Paediatrics in adult critical care – Burns– Cardiac – Neurological – Major Trauma

References • Faculty of Intensive Care Medicine, Intensive Care Society (2015) Guidelines for the

Provision of Intensive Care Services. 1st Edition. Joint standards committee. FICM, ICS

• Faculty of Intensive Care Medicine, Intensive Care Society (2013) Core Standards for ICU. 1st Edition. Core standards working party. FICM, ICS

• National Competency Framework for Adult Critical Care Nurses (2015) Critical Care Nurse Education Review Forum on behalf of the Critical Care National Network Lead Nurse Forum (CC3N)

• National Standards for Critical Care Nurse Education: A framework to improve educational outcomes and quality (2012) Critical Care Nurse Education Review Forum on behalf of the Critical Care National Network Lead Nurse Forum (CC3N)

• NMC Mentorship (2008) Standards to support learning and assessment in practice. NMC standards for mentors practice teachers and teachers.