The Development of Clinical Supervision Model for Prevention of Hospital Acquired Pneumonia.

Abstract

Abstract

                This research and development study consisted of 4 steps: (1) preparation and situation study; (2) development of the model and clinical supervision manual; (3) model trial and revision; and (4) model implementation and evaluation. The purposive sample composed of 14 head and deputy head nurses, 70 professional nurses, and 136 patients, who were at risk of hospital-acquired pneumonia and did not use ventilator. The research instrument included a clinical supervision situation survey and the clinical supervision manual, that were reviewed by three experts yielding content validity Index of 1.00. Data collection instruments consisted of a supervisor questionnaire, a supervisee questionnaire, the patient questionnaire, yielding reliability of .84, .86, and .89 respectively, including hospital-acquired pneumonia incident recording form. Data were analyzed using descriptive and inferential statistics.

                The results found that the clinical supervision model consisted of two components: (1) providing knowledge on clinical supervision to supervisors and providing knowledge on practices to prevent hospital-acquired pneumonia  to professional nurses; and (2) the clinical supervision manual, that included: 2.1 understanding the supervision issues; 2.2 setting the supervision goals; 2.3 analyzing the current situation of the supervision issues; 2.4 determining alternative actions to achieve the supervision goals; and 2.5 joining summary of  the supervision results. The model implementation revealed that the supervisors had significantly higher knowledge and supervisory skills than before using the model (p < .05) and were highly satisfied (Mean 4.75, SD .33). The supervisees had significantly higher knowledge and nursing practices to prevent hospital-acquired pneumonia than before using the model (p < .05) and were highly satisfied (Mean 4.68, SD .34). The patients were highly satisfied (Mean 2.89, SD .84). The incidence of hospital-acquired pneumonia decreased from 0.29 to 0.13 per 1,000 patient-days.