An Integrative Review of Specialised Nursing Career Frameworks to Develop a Nursing Career Framework for Registered Nurses Working in Aged Care.

aimThe aim of this study is to synthesise literature on specialised nursing career frameworks to inform the development of an aged care nursing career framework.

designAn integrative review was conducted.

methodThe review followed Whittemore and Knafl's five-step integrative review method. To appraise the quality of the studies, the Quality Appraisal for Diverse Studies tool for peer-reviewed articles and the ACCODS (Authority, Accuracy, Coverage, Objectivity, Date, and Significance) checklist for grey literature were used. Data were extracted and synthesised using the constant comparison method. DATA SOURCE: The electronic databases of CINAHL, Medline, PsycINFO and Google Scholar were searched to identify peer-reviewed articles and grey literature reporting on specialised nursing career frameworks for registered nurses.

resultsEight studies were reviewed, and the findings were presented corresponding to each of the three research questions of the review. First, the research methods adopted to develop specialised nursing career frameworks were described based on the research design, stakeholder involvement and data collection methods. Second, the key elements of specialised nursing career frameworks were identified as career pathways, nursing competencies and roles and progression between the career levels. Third, the findings suggested that the key purposes for developing specialised nursing career frameworks are to improve professional development, recruitment and retention and to promote consistency and quality in nursing practice.

conclusionThe study highlights a significant gap in the evidence base of career frameworks for registered nurses in aged care, emphasising the need for future research. This review answered three research questions: methods for developing specialised nursing career frameworks, their key components and main purposes, providing insights to guide healthcare organisations and researchers. The findings indicate that career frameworks are primarily intended to promote knowledge and skills development and may also to bolster recruitment and retention rates, and support nurses' career advancement, but there is limited evidence on implementation, evaluation and sustainability. IMPLICATIONS FOR THE PROFESSION: The findings will guide healthcare organisations and future researchers with methods and techniques to develop specialised nursing career frameworks. Implementing a specialised nursing career framework in aged care could enhance continuous professional development, recruitment, retention and career progression among nurses. IMPACT: Nursing career frameworks have been widely applied to address professional development and retention objectives. However, there is limited evidence available to formulate a career framework for registered nurses working in aged care. The review identified the research methods adopted to develop specialised nursing career frameworks along with the key elements of specialised nursing career frameworks. These findings will guide employers and future researchers in developing evidence-based aged-care nursing career frameworks. Additionally, the findings will guide registered nurses in using career frameworks as a tool to facilitate career advancement and competency development. Furthermore, the review recognised the key purposes for developing specialised nursing career frameworks, suggesting that the meaningful adoption of career frameworks could be utilised as a strategic approach for enhancing retention and workforce development of the aged care workforce. REPORTING

methodThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was used for reporting. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

trial registrationThe integrative review protocol was registered in the PROSPERO international prospective register of systematic reviews database (registration no: CRD42022354728).