Working together: The Development of a Career Structure and Conceptual Framework for critical care nursing for Zambia

Carter, Chris (2025) Working together: The Development of a Career Structure and Conceptual Framework for critical care nursing for Zambia. Doctoral thesis, Birmingham City University.

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Abstract

Background & Rationale: This thesis is a PhD study which developed a career structure and conceptual framework for critical care nursing (CCN) in Zambia. Zambia is a low-income country in Sub-Saharan Africa and at the start of the study in 2017, had fledgling critical care services, no career structure, and no recognition of specialist practice. A critical review of the literature identified the unique nature and lack of critical care and a paucity of context specific career structures and conceptual framework for education and practice. In consequence, as the study progressed it grew exponentially to develop the requisite new knowledge to develop a career structure and conceptual framework.

Aims: The aims of this study were:

To develop and implement a culturally competent, culturally safe, and sustainable career structure and conceptual framework for critical care nurse education and practice in Zambia.

To develop policy recommendations for a career structure for critical care nurses.

Methods: A participatory co-operative inquiry, mixed methods approach underpinned by ubuntu, an African philosophy was used. This included national e-survey questionnaires, focus groups, research workshops, documentary data analysis and a national cross-sectional survey.

Findings: Datasets revealed the remit of CCN extended beyond the physical critical care unit, with nurses leading services but without recognition. They had a formal and informal extended scope of practice which did not match their education level. Key stakeholders agreed the need address the imbalance in education opportunities for CCNs to service provision. As part of the study a mentorship model, definition and scope of practice and career structure were developed. These outputs and datasets were then used to inform the development of a conceptual framework for CCN in Zambia.

Conclusion: The career structure and conceptual framework were accepted by the Ministry of Health and the nursing regulator, and these are now being implemented. Bonus outputs have been the successful use of ubuntu as a research and education tool. There has also been a series of peer reviewed publications and national and international recognition for the outputs from this study.

Item Type:	Thesis (Doctoral)
Dates:	Date Event 15 August 2025 Accepted
Uncontrolled Keywords:	Career structure, Conceptual framework, Critical care, Low-income country, Nursing.
Subjects:	CAH02 - subjects allied to medicine > CAH02-04 - nursing and midwifery > CAH02-04-01 - nursing (non-specific) CAH02 - subjects allied to medicine > CAH02-04 - nursing and midwifery > CAH02-04-09 - others in nursing CAH22 - education and teaching > CAH22-01 - education and teaching > CAH22-01-01 - education
Divisions:	Doctoral Research College > Doctoral Theses Collection Life and Health Sciences > Health and Social Care Professions > Health Care
Depositing User:	Louise Muldowney
Date Deposited:	15 Dec 2025 10:02
Last Modified:	15 Dec 2025 10:02
URI:	https://www.open-access.bcu.ac.uk/id/eprint/16771

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