Study Protocol for the Development of an African Framework for Critical Care Nursing based on Ubuntu using Co-operative Inquiry: Decolonising Care

Background: Critical care nursing in Zambia is a new speciality that has adopted traditional nursing documentation, and currently use the Roper, Logan and Tierney Activities of Daily Living combined with NANDA International (NANDA-I) criteria. It is a cause for concern these models are based on different high-income domains, and are not critical care or context specific, making integration and application in practice challenging. Therefore, there is an urgent need to develop a Zambian context specific critical care nursing framework.

Aims and Objectives: This study aims to explore intensive care nurses’ perceptions of the applicability of currently used nursing models and theories and to develop a new Zambian critical care nursing framework based on the principles of Ubuntu.

Methods: A participatory co-operative inquiry, mixed method study with two phases. Phase 1 includes a retrospective review of nursing care plan documentation. This will allow for the identification of the current use of nursing models and theories. Phase 2 will utilise the findings from phase 1 as the basis for a series of focus groups with intensive care nurses.
Phase 1 utilises documentary data analysis to identify key nursing documentation over a 2-month period. Descriptive statistics and where possible significant difference will be used to determine patterns and trends.
Phase 2 comprises of semi-structured focus groups with intensive care nurses within the study site. Total population sampling will be used; therefore, all nurses will be invited to participate. Framework analysis will be used to analyse the qualitative datasets using.

Conclusion: The outcomes will illustrate the efficiency and effectiveness of nursing documentation and perceptions of using the current nursing model. The findings will be combined to develop a critical care nursing framework based on Ubuntu, which will then be piloted.

What is Known About This Topic:
•Critical care provision in low and low-middle income countries is increasing, with nursing care often based on models from High-Income Country.
•There is increasing recognition for the need of context specific nursing models in this setting
•Ubuntu has been identified as an emerging model of nursing within the central, southern African region; however, it’s use in critical care is unknown.

What This Paper Adds
•This study provides a methodological framework to assess and evaluate the extent to which current nursing models are used in critical care practice.
•The framework developed will provide an example of the application of a context specific African philosophy in supporting the development of critical care nursing as an emerging speciality in Africa.
•This study is one of the first context specific critical care nursing research projects to evaluate the current critical care nursing model to develop a new culturally appropriate critical care nursing framework