1
|
Coughtrey AE, Bennett SD, Stanick C, Chorpita B, Dalrymple E, Fonagy P, Helen Cross J, Ford T, Heyman I, Moss-Morris R, Shafran R. Training and supervision of physical health professionals to implement mental health care in paediatric epilepsy clinics. Epilepsy Behav 2024; 157:109905. [PMID: 38909460 DOI: 10.1016/j.yebeh.2024.109905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 06/03/2024] [Accepted: 06/13/2024] [Indexed: 06/25/2024]
Abstract
BACKGROUND Children and young people with epilepsy are more likely to experience multiple mental health problems than those without chronic physical health conditions, yet they often do not receive evidence-based (or indeed any) psychological interventions. Integrated healthcare is recommended as a solution to address these inequalities, but remains limited in the United Kingdom. This is partly due to the lack of training and availability of ongoing supervision for clinicians to ensure the safe and effective delivery of treatments. This study aimed to train and provide supervision for health professionals to deliver a modular cognitive-behavioural intervention for common mental health problems, optimised for use in paediatric epilepsy. Specifically, this study aimed to measure therapist competence and evaluate the acceptability of training and supervision. METHODS Fifteen health professionals working in paediatric epilepsy services were trained over a six-month period. Training included face-to-face training workshops and completing at least one training case of a young person with epilepsy and anxiety, depression and/or behavioural problems under close clinical supervision. Throughout the training, health professionals were offered weekly one-hour supervisions with an experienced Clinical Psychologist. Clinical competence was assessed using a widely used measure of therapist competence in cognitive-behavioural therapy. Rates of attendance at supervision sessions and therapist ratings of satisfaction were recorded. RESULTS At the end of the six-month training, 14 health professionals reached clinical competence in delivering the mental health intervention. One person left the service and therefore did not complete the training. Overall, health professionals were satisfied with the training and supervision. However, 14 % of supervision sessions were cancelled and a further 11 % were not attended. Supervision sessions were also often shorter than the standard hour used in mental health settings (M = 41.18 min, SD = 10.30). CONCLUSIONS Our findings suggest that health professionals working in paediatric epilepsy services can be trained to deliver a psychological intervention with proficiency. However, the supervision model typically used in mental health may need adaptation to be sustainable in physical health settings. Future research is needed to evaluate the impact of training and supervision on patient outcomes and to ensure that ethical delivery of psychological interventions by health professionals without a mental health background.
Collapse
Affiliation(s)
- Anna E Coughtrey
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, UK; Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, UK.
| | - Sophie D Bennett
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, UK; Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, UK; Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Cameo Stanick
- Sycamores-Hathaway Centre for Excellence, Los Angeles, CA, USA; UCLA Los Angeles, CA, USA
| | | | - Emma Dalrymple
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, UK; Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, UK
| | - Peter Fonagy
- Division of Psychology & Language Sciences, University College London, London, UK
| | - J Helen Cross
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, UK; Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, UK
| | - Tamsin Ford
- Department of Psychiatry, Cambridge University, Cambridge, UK; Cambridge and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Isobel Heyman
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, UK; Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, UK; Department of Psychiatry, Cambridge University, Cambridge, UK; Cambridge and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Rona Moss-Morris
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Roz Shafran
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, UK; Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, UK
| |
Collapse
|
2
|
Doody O, O'Donnell C, Murphy L, Turner J, Markey K. The establishment and value of peer group clinical supervision: A qualitative study of stakeholders' perspectives. J Clin Nurs 2024. [PMID: 38837472 DOI: 10.1111/jocn.17315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 05/10/2024] [Accepted: 05/20/2024] [Indexed: 06/07/2024]
Abstract
AIMS Explore perspectives of steering group members and external clinical supervision facilitators of developing and establishing peer group clinical supervision. BACKGROUND The climate of healthcare is complex which can lead to staff burnout and challenges to practice. Clinical supervision is suggested as an approach to managing and leadership of such complexities. DESIGN Qualitative descriptive. METHODS Focus group interviews with 19 members of the peer group clinical supervision steering groups and individual interviews with five external clinical supervision facilitators from the Western region of Ireland were conducted. Data analysis followed Elo and Kyngäs' content analysis method, involving preparation, organising and reporting, to extract meaning and identify patterns from the qualitative data collected. RESULTS Developing peer group clinical supervision practice requires, clarity of purpose and function that address the pros and cons of clinical supervision. Organisational leadership is required to support and release staff for peer group clinical supervision and peer group clinical supervisors need to be credible and have a level of expertise in practice. When prepared and supported, the aspects of confidence, leadership, personal development and resilience develop. CONCLUSION Peer group clinical supervisors need training and ongoing continual professional development for their role, scope of practice and responsibilities. Sustainability rests on staff awareness and familiarity with the purpose and format of peer group clinical supervision and the regularity of sessions. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Peer group clinical supervision is a means of supporting improvement of patient care delivery while in parallel supporting personal and professional development of staff, building resilience in the workplace. IMPACT This study explored the implementation of peer group clinical supervision for staff across nursing and midwifery disciplines. It found that implementing peer group clinical supervision had a positive impact on staff well-being and morality and on patient care delivery. These findings influence healthcare service providers in implementing peer group clinical supervision in a sustainable way enabling nurses to continue working in complex healthcare environments delivering safe person-centred care. REPORTING METHOD The qualitative reporting guidelines Standards for Reporting Qualitative Research (SRQR) were followed. PATIENT OR PUBLIC CONTRIBUTION Patient/public involvement was addressed in this study by staff, managers, planners, directors, leaders and educationalists being involved at all stages of the study (concept, design, analysis and reporting).
Collapse
Affiliation(s)
- Owen Doody
- Department of Nursing and Midwifery, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Claire O'Donnell
- Department of Nursing and Midwifery, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Louise Murphy
- Department of Nursing and Midwifery, Health Research Institute, University of Limerick, Limerick, Ireland
| | - James Turner
- Department of Nursing and Midwifery, Sheffield Hallam University, Sheffield, UK
| | - Kathleen Markey
- Department of Nursing and Midwifery, Health Research Institute, University of Limerick, Limerick, Ireland
| |
Collapse
|
3
|
Tulleners T, Taylor M, Campbell C. Contribution of peer group supervision to nursing practice: An interpretive phenomenological study. Nurse Educ Pract 2024; 75:103903. [PMID: 38271915 DOI: 10.1016/j.nepr.2024.103903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 12/15/2023] [Accepted: 01/16/2024] [Indexed: 01/27/2024]
Abstract
AIM To provide insight into peer group supervision practices through understanding the lived experience of community health nurses. BACKGROUND The recent Covid-19 health crisis highlights the importance of supportive mechanisms to sustain and retain nurses in the workforce. While the support of quality clinical supervision for registered nurses is recognised, the benefits and challenges of peer group supervision are less clearly articulated. DESIGN Nurses' experiences of peer group supervision in an Australian tertiary health service were explored using a Gadamerian philosophical hermeneutic approach. METHOD Semi-structured in-depth interviews were conducted in 2021 and provided nurses with the opportunity to share their experiences of using the New Zealand Coaching and Mentoring Model of peer group supervision. The study included a total of 31 nurse participants across multiple community health contexts. Interview data were analysed using a hermeneutic approach from which themes arose. FINDINGS The findings demonstrated that strong peer group supervision foundations that include personal and professional preparation and active participation are essential. Dual pillars of "the unique individual" and "the unique group" with responsibilities identified in each pillar that enable interactions and worthiness in peer group supervision practice. The foundations and pillars support peer group supervision in nursing practice to provide a mechanism for reflection, support and professional guidance. CONCLUSIONS Peer group supervision is a worthy, contributory process in community health nursing when implementation processes are supported and teams are educated and prepared. Perceptions of peer group supervision are unique and varied across individuals. The individual experience has an impact on the group experience and vice versa. Knowledge of the process and group by participants is required to enable professional reflection through nursing peer group supervision.
Collapse
Affiliation(s)
- Tracey Tulleners
- School of Nursing and Midwifery, University of Southern Queensland, 11 Salisbury Rd, Ipswich 4305, Australia.
| | - Melissa Taylor
- School of Nursing and Midwifery, University of Southern Queensland, 11 Salisbury Rd, Ipswich 4305, Australia; Centre for Health Research, University of Southern Queensland, 11 Salisbury Rd, Ipswich 4305, Australia.
| | - Christina Campbell
- School of Psychology and Wellbeing, University of Southern Queensland, 11 Salisbury Rd, Ipswich 4305, Australia.
| |
Collapse
|
4
|
Catling C, Davey R, Donovan H, Dadich A. A metasynthesis of nurses and midwives' experiences of clinical supervision. Women Birth 2024; 37:6-14. [PMID: 37891028 DOI: 10.1016/j.wombi.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/11/2023] [Accepted: 10/20/2023] [Indexed: 10/29/2023]
Abstract
PROBLEM Given the current rate of burnout and attrition among nurses and midwives globally, there is a need to understand the effectiveness of supportive strategies to help retain this workforce. BACKGROUND Clinical supervision can help to ensure that nurses and midwives are supported and have the capacity to cope with their job demands. Yet there are no metasyntheses that provide a collective understanding of their experiences with clinical supervision. AIM To synthesise the experiences of nurses and midwives who have accessed clinical supervision. METHODS A metasynthesis was conducted by systematically searching academic databases for relevant publications; assessing their quality using an established checklist; extracting and analysing qualitative content; and synthesising key findings about the experiences of nurses and midwives regarding clinical supervision. FINDINGS Themes and subthemes were identified from 12 papers, including: optimal logistics; support; safety and confidentiality; improving practice through reflection; and trust in the group. DISCUSSION For clinicians to feel comfortable discussing their practice and workplace with the facilitator and colleagues, nurses and midwives needed to feel safe during clinical supervision and trust the process and their peers. Despite common difficulties of finding time for the sessions, clinical supervision can enhance collaboration and communication in the workplace. CONCLUSION Clinical supervision that adheres to group rules can provide professional support within a safe, confidential space. Having trust in peers and facilitators at the sessions can help staff develop confidence, provide personal development and professional sustenance.
Collapse
Affiliation(s)
- Christine Catling
- University of Technology Sydney, Broadway PO Box 123, NSW 2007, Australia.
| | - Rachel Davey
- School of Business, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Helen Donovan
- University of Technology Sydney, Broadway PO Box 123, NSW 2007, Australia
| | - Ann Dadich
- School of Business, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
| |
Collapse
|
5
|
Atashi V, Movahedi Najafabadi M, Afshari A, Ghafari S. Barriers to effective clinical supervision from the perspective of nurses: A descriptive qualitative study. Nurs Open 2024; 11:e2028. [PMID: 38268257 PMCID: PMC10721941 DOI: 10.1002/nop2.2028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 09/29/2023] [Indexed: 01/26/2024] Open
Abstract
AIM The present study aimed to explain the barriers to effective clinical supervision from the perspective of nurses. DESIGN Qualitative descriptive study. METHODS The present study enrolled 21 nurses selected by purposive sampling. Data were collected through semi-structured interviews, which were digitally recorded and immediately transcribed verbatim, and analysed using content analysis method. RESULTS From the nurses' perspective, the influential barriers included poor academic, ethical, communicational, professional competencies at the passive management level, defects in supervision prerequisites, conventional beliefs, ineffective organization, shortage of workforce at the level of inappropriate context, lack of motivation and poor accountability at inadequate professional maturity level. PUBLIC CONTRIBUTION The following items affect how clinical supervision is implemented: Motivation, accountability at the personal level, sufficient workforce, conducive conditions, effective organization of resources, and preparing the individual for supervision at the organizational level to implement effective clinical supervision.
Collapse
Affiliation(s)
- Vajihe Atashi
- Nursing and Midwifery Care Research Center, Adult Health Nursing DepartementIsfahan University of Medical SciencesIsfahanIran
| | | | - Atefeh Afshari
- Nursing and Midwifery Care Research Center, Department of Community Health Nursing, Faculty of Nursing and MidwiferyIsfahan University of Medical SciencesIsfahanIran
| | - Somayeh Ghafari
- Nursing and Midwifery Care Research Center, Department of Critical Care Nursing, Faculty of Nursing and MidwiferyIsfahan University of Medical SciencesIsfahanIran
| |
Collapse
|
6
|
Awiagah SK, Dordunu R, Hukporti N, Nukunu PE, Dzando G. Barriers and Facilitators to Clinical Supervision in Ghana: A Scoping Review. SAGE Open Nurs 2024; 10:23779608241255263. [PMID: 38784649 PMCID: PMC11113047 DOI: 10.1177/23779608241255263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 12/26/2023] [Accepted: 04/28/2024] [Indexed: 05/25/2024] Open
Abstract
Background Clinical supervision involves the professional relationship between an experienced and knowledgeable clinician and a less experienced clinician in which the experienced clinician provides support toward the skills development of the less experienced one. The concept, structure, and format of clinical supervision vary in various jurisdictions and is influenced by the availability of resources, the training needs of supervisees, and organizational structures. Aim The aim of this scoping review was to explore, map out and synthesize the available literature on the facilitators and barriers to clinical supervision in Ghana. Methods The methodological framework developed by Arksey and O'Malley and modified by Levac et al. for scoping reviews, and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews were used to ensure a coherent and transparent reporting of literature. A systematic search was conducted in PubMed, CINAHL, Scopus, Medline, and Google Scholar using key words and key terms. Articles published between January 1, 2000, and February 28, 2023, were included in the review. Results The initial search across all the databases yielded 208 results. Two independent reviewers completed both the title and abstract, and full text screenings. A third reviewer helped to resolve all discrepancies that arose during the screening process. The review included 20 articles and generated four themes: clinical supervision as a collaborative effort, feedback mechanism, training and adaptation, and challenges with implementation. Conclusion Findings from this review highlight that healthcare professionals in Ghana valued clinical supervision. However, the implementation of clinical supervision is faced with individual and systemic challenges. There is the need for on-going collaboration between educational and clinical institutions to develop modalities that promote clinical supervision in Ghana.
Collapse
Affiliation(s)
| | - Rebecca Dordunu
- School of Nursing and Midwifery, University of Ghana, Legon, Ghana
| | - Nelson Hukporti
- The Dudley Group NHS Foundation Trust, Russells Hall Hospital, Dudley, UK
| | - Promise Edem Nukunu
- Department of Allied Health Professions, King Graduate school, Monroe College, USA
| | - Gideon Dzando
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, Australia
| |
Collapse
|
7
|
O'Neill A, Hooker L, Edvardsson K. 'What is it we are trying to achieve here'? Community maternal and child health nurses and clinical supervision: A qualitative descriptive study. J Adv Nurs 2023; 79:3837-3847. [PMID: 37283322 DOI: 10.1111/jan.15725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 04/11/2023] [Accepted: 05/16/2023] [Indexed: 06/08/2023]
Abstract
AIMS To explore clinical supervision practice by Victorian Maternal and Child Health nurses, identify the self-reported supervision needs of nurses and the facilitators and barriers to meeting those needs. BACKGROUND Community-based Maternal and Child Health nurses have responsibilities for the safety and wellbeing of children and specific clinical support needs. Clinical supervision has the potential to support nurses' clinical practice and reflective skills; however, little is known internationally about child and family health nurses' supervision practices. DESIGN Qualitative descriptive study. METHODS Twenty-three semi-structured interviews were conducted between October and December 2021 with nurses, managers and supervisors across metropolitan, regional/rural areas of Victoria, Australia. Inductive thematic analysis was applied to the data. The Consolidated Criteria for Reporting Qualitative Research guided this study. RESULTS Three main themes, with subthemes were generated; 'Understand what we do', 'It's the gathering of the nurses' and 'Bringing a case'. A lack of agreed purpose, aims and varied understandings of clinical supervision contributed to suboptimal clinical supervision. Although participants agreed about the importance of clinical supervision, the perceived benefits were inconsistently realized. CONCLUSIONS This study points to a need for greater organizational awareness of the conditions and leadership needed to build reflective skills and culture in community-based child and family nursing. REPORTING METHOD The Consolidated Criteria for Reporting Qualitative Research has guided this study. NO PATIENT OR PUBLIC CONTRIBUTION There was no patient or public contribution in the conduct of this study. IMPACT A stronger focus is needed to build reflective culture and skill in child and family nursing. Areas for improving child and family nurses' use of clinical supervision have been identified. This study can inform nurse education, policy and service leaders, to strengthen clinical supervision in child and family nursing contexts.
Collapse
Affiliation(s)
- Anne O'Neill
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Australia
| | - Leesa Hooker
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Australia
- Rural Department of Nursing and Midwifery, La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - Kristina Edvardsson
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Australia
| |
Collapse
|
8
|
Kasdovasilis P, Cook N, Montasem A. Sustaining Resilience of Healthcare Workers and Leaders during a Pandemic: A Protocol to Support Coping during the COVID-19 Pandemic. Psychiatry 2023; 86:329-343. [PMID: 37707877 DOI: 10.1080/00332747.2023.2246847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
Objective: One way healthcare organisations can support their staff is through supervision. Supervision is typically defined as a process in which professionals receive support and guidance from more experienced colleagues. In this brief review we propose a tailored protocol for supporting support workers during a pandemic. Method: We collected narrative data from difference sources including a systematic meta ethnography and used expert advise in order to tailor the protocol. Results: This protocol can be used by management teams (e.g., senior support workers, team leaders, registered managers, and operation managers) without any prior experience of supervision. The protocol suggested includes a template with easy-to-follow instructions. Conclusions: It provides an easy step-by-step guide that simplifies the process whilst maintaining the depth needed to ensure effective supervision.
Collapse
|
9
|
McCallum K. Overcoming the barriers to optimal end of life care in the emergency department. Emerg Nurse 2023:e2170. [PMID: 37667653 DOI: 10.7748/en.2023.e2170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2023] [Indexed: 09/06/2023]
Abstract
The focus of care in the emergency department (ED) is on saving or sustaining life, but some patients admitted to the ED die in the ED. Nurses whose focus is on saving lives may therefore find themselves providing end of life care to patients and their families in a stressful and distressing environment. Providing optimal end of life care involves reflecting on what a good death looks like and how patients can be supported to have a good death. This article describes the barriers to optimal end of life care in the ED and prompts nurses to think about how they can enhance their practice when caring for dying patients and their families.
Collapse
Affiliation(s)
- Kay McCallum
- acute oncology, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, England
| |
Collapse
|
10
|
Smythe A, Flatt C, Mahachi L, Whatley V. Introduction of the professional nurse advocate role using a quality implementation framework. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2023; 32:378-383. [PMID: 37083383 DOI: 10.12968/bjon.2023.32.8.378] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
BACKGROUND Implementation of the professional nurse advocate (PNA) role and the Advocating and Educating for QUality ImProvement model (A-EQUIP) in nursing is relatively new. The model aims to build personal and professional resilience, enhance the quality of care and support preparedness for appraisal and professional revalidation. AIM To describe the implementation of the PNA role in a combined acute and community trust in England. METHODS A quality implementation framework was used to appraise and represent locally derived strategic activities for successful implementation of the role in an acute and community hospital in England. The content of this framework was derived from a synthesis of 25 implementation frameworks focusing on important elements understood to represent quality implementation. FINDINGS The article identifies strengths and weaknesses to implementation and ways to sustain early implementation success. CONCLUSION Using a quality implementation framework can provide a clear path for the successful implementation of the professional nurse advocate role. Professional nurse advocates should be supported to develop a culture of effective supervision within their organisation.
Collapse
Affiliation(s)
- Analisa Smythe
- Research Matron, The Royal Wolverhampton NHS Trust, and Visiting Fellow, Staffordshire University, Stafford
| | - Claire Flatt
- Lead for Nursing, Midwifery & AHP Leadership Development, The Royal Wolverhampton NHS Trust, Wolverhampton
| | - Loraine Mahachi
- Endoscopy Nurse Lead, The Royal Wolverhampton NHS Trust, Wolverhampton
| | - Vanessa Whatley
- Director of Quality and Safety, NHS Shropshire Telford and Wrekin Integrated Care Board, Shropshire
| |
Collapse
|
11
|
Acupuncture Case Registry Study: Rationale, Implementations, and Achievements. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:3860231. [DOI: 10.1155/2022/3860231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 10/10/2022] [Indexed: 11/22/2022]
Abstract
The acupuncture case registry study is focusing on acupuncture therapy data from patient cases. The main objective is to collect real-world data and integrate clinically meaningful outcome evaluation indicators to uncover and evaluate real-world acupuncture efficacy and safety, explore factors affecting acupuncture efficacy, and provide real-world evidence to complement RCTs. Since the International Acupuncture Case Registry data collection system’s establishment in 2017, 16 projects have been underway, including two acupuncture specialty therapies and 15 diseases. Data from 3404 patients included extensive information on the diagnosis and treatment of acupuncture and the evaluation of its efficacy. In order to serve as a guide for future studies, this article discusses the value of and rationale for establishing acupuncture case registry studies, how to distinguish them from patient registries, and crucial techniques for implementing registry studies in terms of applications, patient recruitment, costakeholder collaboration, data collection and management, study quality control, and ethics.
Collapse
|
12
|
Anggeria E, Damanik DW. Effective Clinical Supervision in Nursing: Systematic Review. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Clinical supervision is part of the leadership function to observe and evaluate the nursing care process, affecting service delivery and improving employee skills.
AIM: This systematic review was designed to evaluate effective clinical supervision in nursing.
METHODS: Databases were searched for relevant studies: Google Scholar, PUBMED, ScienceDirect, and ProQuest to study screening tools used to identify effective clinical supervision in nursing that were published within 2011-2022. Information about purpose, method, and result. The quality of the study was assessed using equipment from the Manchester Clinical Supervision Scale (MCSS). Validation and reliability were performed on all instruments. Data reliability using Cronbach's coefficient.
RESULTS: Data from retrieved studies were reviewed and tabulated according to purpose, study design, characteristics of the population, and result. Eight hundred twenty-nine identified references and 12 full-text articles were reviewed, and 8 for eligibility which has been tested and included in a systematic review, and articles have instruments with included criteria.
CONCLUSION: Limitations of effective clinical supervision of the head of the department. The organization is very important because a private hospital can work effectively if there is a healthy and supportive working environment between management and employees. Therefore, future research should focus on using clinical supervision in the health care system to identify effective supervision.
Collapse
|
13
|
Masamha R, Alfred L, Harris R, Bassett S, Burden S, Gilmore A. 'Barriers to overcoming the barriers': A scoping review exploring 30 years of clinical supervision literature. J Adv Nurs 2022; 78:2678-2692. [PMID: 35578563 PMCID: PMC9546137 DOI: 10.1111/jan.15283] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 04/01/2022] [Accepted: 04/26/2022] [Indexed: 11/28/2022]
Abstract
Aims/Questions To explore the barriers and facilitators to nurses accessing clinical supervision; explore the barriers and facilitators to organizations implementing clinical supervision and capture what skills nurses require to facilitate clinical supervision. Design Scoping review of peer‐reviewed research and grey literature. Data sources CINAHL, Medline, PsychINFO and Scopus were searched for relevant papers published between 1990 and 2020. Google, Google Scholar, OpenGrey & EThOS were used to search for grey literature. Review Methods PRISMA‐ScR guidelines were used during the literature review process. Eighty‐seven papers were included, and data were extracted from each paper using a standardized form. Data synthesis was undertaken using Seidel's analytical framework. Results Five themes were identified: Definitions and Models, (Mis) Trust and the Language of Supervision, Alternative Parallel Forums and Support Mechanisms, Time and Cost and Skills required. Conclusion Since its inception in the 1990s, clinical supervision has long been regarded as a supportive platform for nurses to reflect on and develop their practice. However, this review highlights that despite an awareness of the skills required for nurses to undertake clinical supervision, and the facilitators for nurses to access and organizations to implement clinical supervision, there have been persistent barriers to implementation. This review identifies these persistent factors as ‘barriers to overcoming the barriers' in the clinical supervision landscape. These require critical consideration to contribute towards moving clinical supervision forward in the spirit of its original intentions. Impact This review progresses the debate on clinical supervision through critically analysing the barriers to overcoming the barriers. To this end, the review is designed to stimulate critical discussions amongst nurses in different clinical spaces and key stakeholders such as policy makers and regulatory bodies for the nursing profession.
Collapse
Affiliation(s)
- Roselyne Masamha
- Department of Psychological Health Well-being and Social Work, University of Hull, Hull, UK
| | - Lolita Alfred
- School of Health Sciences, City University of London, London, UK
| | - Ruth Harris
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Sally Bassett
- Faculty of Health and Life Sciences, Headington Campus, Oxford Brookes University, Oxford, UK
| | - Sarah Burden
- School of Health, Leeds Beckett University, Leeds, UK
| | | |
Collapse
|
14
|
Kaur-Aujla H, Lillie K, Wagstaff C. Prognosticating COVID Therapeutic Responses: Ambiguous Loss and Disenfranchised Grief. Front Public Health 2022; 10:799593. [PMID: 35493360 PMCID: PMC9039248 DOI: 10.3389/fpubh.2022.799593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
Conventionally, therapeutic assessments, interventions, and treatments have focussed on death-related "losses and grief" responses. It is purported that the COVID-19 aftermath has resulted in losses that cannot always be encapsulated using this method. In search of reasoning, models and theories that explain the sweeping mass destruction that COVID-19 has caused, key concepts arise in terms of how we should deal with losses and in turn support patients in the health and social care sector, (notwithstanding formal therapeutic services). There is a crucial need to embrace ambiguous loss and disenfranchised grief into everyday terminology and be acquainted with these issues, thereby adapting how services/clinicians now embrace loss and grief work. Integral to this process is to recognize that there has been a disproportionate impact on Black and minority ethnic communities, and we now need to ensure services are "seriously culturally competent." Primary Care services/IAPT/health and social care/voluntary sector are all likely to be at the forefront of delivering these interventions and are already established gatekeepers. So, this article discusses the prognostic therapeutic response to non-death related losses and grief, not restricted to the formal echelons of therapeutic provision.
Collapse
Affiliation(s)
- Harjinder Kaur-Aujla
- Institute of Clinical Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Kate Lillie
- Institute of Clinical Sciences, Keele University, Keele, United Kingdom
| | - Christopher Wagstaff
- Institute of Clinical Sciences, University of Birmingham, Birmingham, United Kingdom
| |
Collapse
|
15
|
Mc Carthy V, Goodwin J, Saab MM, Kilty C, Meehan E, Connaire S, Buckley C, Walsh A, O'Mahony J, O'Donovan A. Nurses and midwives' experiences with peer-group clinical supervision intervention: A pilot study. J Nurs Manag 2021; 29:2523-2533. [PMID: 34213054 DOI: 10.1111/jonm.13404] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/11/2021] [Accepted: 06/23/2021] [Indexed: 11/28/2022]
Abstract
AIM This study aimed to evaluate differences in supervisees' understanding of clinical supervision and their perceptions of organisational functioning before and after engaging in peer-group clinical supervision. BACKGROUND Protected reflective time allows discussion of complex issues affecting health care. Peer-group clinical supervision is one model of clinical supervision that could facilitate this, but it is poorly understood. METHODS A pre-post intervention pilot study was performed. The intervention was delivered over a 12-month period. Data were collected using surveys on demographic and work-related factors and experience of clinical supervision pre- and post intervention. RESULTS Adaptability increased significantly between the pre- and post surveys. The post survey data showed finding time for clinical supervision scoring lowest with open-ended comments reinforcing this. The supervisees found the sessions to offer a safe place despite initial concerns. CONCLUSION The peer-group model of clinical supervision allowed supervisees to build a rapport and trust with their colleagues and share experiences. IMPLICATIONS FOR NURSING MANAGEMENT The benefits to participating in peer-group clinical supervision traversed the individual and organisation. These data support the implementation of such sessions while addressing workload and time pressures to aid participation.
Collapse
Affiliation(s)
- Vera Mc Carthy
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - John Goodwin
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Mohamad M Saab
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Caroline Kilty
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Elaine Meehan
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Sinead Connaire
- Nursing and Midwifery Planning and Development Unit, Health Service Executive, Dublin, Ireland
| | - Carmel Buckley
- Nursing and Midwifery Planning and Development Unit, Health Service Executive, Dublin, Ireland
| | - Anne Walsh
- Nursing and Midwifery Planning and Development Unit, Health Service Executive, Dublin, Ireland
| | - James O'Mahony
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Aine O'Donovan
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| |
Collapse
|
16
|
Nursing Education: Students' Narratives of Moral Distress in Clinical Practice. NURSING REPORTS 2021; 11:291-300. [PMID: 34968206 PMCID: PMC8608063 DOI: 10.3390/nursrep11020028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/15/2021] [Accepted: 04/16/2021] [Indexed: 10/29/2022] Open
Abstract
BACKGROUND Research indicates that newly graduated nurses are often unprepared for meeting challenging situations in clinical practice. This phenomenon is referred to as a "reality shock". This gap in preparedness may lead to moral distress. The aim of this article is to provide knowledge of moral distress in clinical nursing practice. METHODS Bachelor and further education nursing students were invited to write a story about challenging situations from their own clinical practice, resulting in 36 stories. Analysis was based on hermeneutical reading inspired by a narrative method; therefore, six stories were selected to represent the findings. RESULTS A finding across the stories is that the students knew the right thing to do but ended up doing nothing. Four themes were related to moral distress: (a) undermining of professional judgement, (b) disagreement concerning treatment and care, (c) undignified care by supervisors, and (d) colliding values and priorities of care. CONCLUSION Nursing education should emphasize to a greater extent ethical competency and training for the challenging situations students will encounter in clinical practice.
Collapse
|
17
|
Mahasneh D, Shoqirat N, Al Hadid L, Alja'afreh MA, Shosha GMA. Nursing students' experience of clinical supervision and contributing factors in Jordan. NURSE EDUCATION TODAY 2020; 92:104515. [PMID: 32652315 DOI: 10.1016/j.nedt.2020.104515] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 04/13/2020] [Accepted: 06/23/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Although clinical supervision is a vital component of nursing education, data on students' experiences of clinical supervision and contributing factors remain limited. AIM The study explores nursing students' experience of clinical supervision and contributing factors in Jordan. DESIGN/METHODS An explorative design with a qualitative approach using focus group discussions (n = 6) was used. A convenient sample consisting of 48 participants was recruited from second, third and fourth year nursing students. Data were thematically analysed using N VIVO 12. RESULTS The analysis revealed two overlapping experiences. First, the empowering supervision experience comprising: "being willing and patient" and "working hand-in-hand" with students. Second, the disempowering supervision experience, including: abuse of power and grade obsession, incompetent supervision and lack of time detected for students. While the former has positivity which enhanced students' clinical learning, the latter reduced their motivation for gaining knowledge and skills and negatively impacted their self-confidence. CONCLUSION Students' experience of clinical supervision is multifaceted. Thus, there is a pressing need for establishing a preparation programme for newly employed supervisors focusing on annual training updates, identifying their competency level and understanding the way their supervisory role is operationalised.
Collapse
Affiliation(s)
- Deema Mahasneh
- Faculty of Nursing, Mutah University, Karak 61710, Jordan.
| | | | - Lourance Al Hadid
- Princess Aisha Bint Al Hussein College of Nursing and Health Sciences, Nursing Department, Al Hussein Bin Talal University, Ma'an 71111, P.O. Box 29, Jordan.
| | - Mahmoud A Alja'afreh
- Department of Adult Health Nursing, Faculty of Nursing, Mutah University, P.O. Box (7), Mutah_Karak 61710, Jordan.
| | | |
Collapse
|
18
|
Foye U, Simpson A, Reynolds L. "Somebody else's business": The challenge of caring for patients with mental health problems on medical and surgical wards. J Psychiatr Ment Health Nurs 2020; 27:406-416. [PMID: 31957244 DOI: 10.1111/jpm.12596] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 01/10/2020] [Accepted: 01/14/2020] [Indexed: 11/29/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: People with mental health problems have higher rates of physical health concerns and hospital admissions than those without mental health problems. These patients have poorer outcomes from surgery and have worse experiences of care when admitted for medical or surgical procedures. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This paper looks to understand why care may be poorer for patients with mental health problems by speaking to staff providing care in these settings. We spoke to 30 general hospital staff about mental health on the wards and found that a lack of leadership and ownership for prioritising mental health led to people not seeing it as their job, and that it was somebody else's business to manage that side of care. We also found that the emotional effect of caring for people who had attempted suicide or had self-harm injuries was difficult for staff, impacting on staff well-being and leading them to distance themselves from providing care in those cases. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: There is a need for staff to be supported from the top-down, with management providing clear leadership around issues and pathways for mental health needs so they know the best way to provide care and encourage collaborative working. In addition, bottom-up support is needed to help staff personally manage their own well-being and mental health, including supervision and debriefing from mental health specialists to improve understanding from the patient's perspective and to provide emotional support to manage difficulties. RELEVANCE STATEMENT: This paper places focus on the care of patients with mental health problems in medical and surgical care settings highlighting the interplay between mental and physical health from a perspective that is less often explored. This paper provides insights into the multidisciplinary nature of nursing and the need for integrated care. This provides findings that build a picture of how mental health nursing specialism is needed beyond psychiatric wards and within medical and surgical settings. ABSTRACT: Introduction Evidence shows that patients with mental health problems have poorer physical health outcomes, increased mortality and experience poorer care during surgery and medical admissions. Issues related to lack of training, stigmatizing attitudes, fear or hopelessness may help understand these poor outcomes. Aim To explore the experiences of staff in providing care for people with mental health problems. Method A qualitative service evaluation approach was used. Participants working in an acute care hospital in inner-city London were recruited across professions and job levels using a self-selection sampling method. A total of 30 participants took part in semi-structured interviews (n = 17) and two focus groups (n = 13), and data were thematically analysed. Relevant organizational documents and service use data were utilized to inform the evaluation. Results Key themes were organized across the macro, meso and micro levels to understand the levels of disconnection and silence around mental health in acute care. Themes include systemic factors surrounding the institutional culture, ward cultures and collaborative working, and individuals' sense-making of mental health and personal well-being. Implications for practice These findings signpost the growing need for greater mental health nursing input on medical and surgical wards and within these teams to provide informed knowledge, support and supervision.
Collapse
Affiliation(s)
- Una Foye
- Department of Mental Health Nursing, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Alan Simpson
- Department of Mental Health Nursing, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Lisa Reynolds
- Division of Nursing, School of Health Sciences, City University of London, London, UK
| |
Collapse
|
19
|
Abstract
Aim: The aim of this study was to describe Child Health Service (CHS) nurses’ experiences with conducting individual parental conversations (IPCs) with non-birthing parents. Background: CHS nurses in Sweden mainly focus on monitoring a child’s physical and mental development and the mothers’ health in order to support their parenthood. The assignment of the CHS includes identifying dysfunctional social relationships in a family and strengthening responsive parenting. An imbalance arises within the family when someone in the family suffers from illness, which could have a negative effect on the whole family’s health and well-being. Methods: An inductive, descriptive qualitative study design was used to describe and to gain an understanding of the CHS nurses’ experiences. Data were collected in 13 interviews, and a qualitative content analysis was performed. Findings: The analysis of interviews with CHS nurses resulted in two main categories, each with three subcategories. The main categories are: working for equality and applying a family focus, and dealing with challenges in the developing assignment. The IPCs stimulate the CHS nurses to work for more equality and to apply a family focus, which can be a way of strengthening the families’ health and the children’s upbringing. Developing the CHS nurses’ assignment can be a challenge that appears to entail positive outcomes for CHS nurses, while also generating the need for CHS nurses to receive supervision to find ways to improve their approach and practice.
Collapse
|
20
|
Harrison Dening K, Scates C, McGill G, De-Vries K. A training needs analysis of admiral nurses to facilitate advance care planning in dementia. Palliat Care 2019; 12:1178224219850183. [PMID: 31258328 PMCID: PMC6585248 DOI: 10.1177/1178224219850183] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 04/04/2019] [Indexed: 11/15/2022] Open
Abstract
Education of health and social care professionals is essential in preparation to confidently and effectively support families affected by dementia to undertake advance care planning. This article describes a training needs analysis of Admiral Nurses, dementia specialists, in facilitating advance care planning for future care. METHODS A questionnaire survey was completed by Admiral Nurses attending end-of-life care masterclasses in 2017 and 2018. Both quantitative (years registered as a nurse, years as an Admiral Nurse and subjective level of confidence in completing advance care plannings) and qualitative data (interventions perceived to increase confidence) were collected. FINDINGS There were 75 completed responses (two incomplete returns). There was no correlation between levels of confidence and years registered as a nurse. However, there was a small positive correlation between confidence and number of years as an Admiral Nurse (r = 0.23; p < 0.05). Themes identified qualitatively to enhance practice were advanced communication skills, supervised practice, resources to frame conversations and a guide and template for advance care planning. CONCLUSION Although Admiral Nurses are specialists in dementia, several educational initiatives could be employed to better enable them to support advance care planning for families affected by dementia. This training needs analysis is contributed towards developing an educational intervention for Admiral Nurses to improve advance care planning support.
Collapse
Affiliation(s)
- Karen Harrison Dening
- Dementia UK, London, UK; Faculty of Health and Life Sciences, School of Nursing and Midwifery, De Montfort University, Leicester, UK
| | | | | | - Kay De-Vries
- Faculty of Health and Life Sciences, School of Nursing and Midwifery, De Montfort University, Leicester, UK
| |
Collapse
|