Development of a Clinical Supervision Model on Nursing Competence and Clinical Outcomes on Stroke Patients at Hatyai hospital

Abstract

Abstract
     Objective: To develop and evaluation the effects of a clinical supervision model on nursing competence and stroke outcomes.
     Methods: The research and development (R&D) model was implemented during October 2018 to June 2020 at medicine wards of Hatyai Hospital, Songkhla. Three steps approach were generated as following: step 1, identification of nurses mentor’s need and limitations pertaining to clinical supervision in stroke care; step 2, development and implementation of clinical supervision model for nurses mentor; and step 3, evaluation of outcomes. Outcome
     Measures: Using pre-post clinical supervision outcomes evaluation. We measured two levels of outcomes including nurses-focused, and patients-focused. Nurses-focused outcomes included nurse mentors supervision competence (n=30) and staff nurses competence on stroke care (n=60), by using performance questionnaires. Patients-focused outcomes were as followed: physical functioning of the stroke patients before discharge (n=1,110) defined by using Barthel Index, and family caregiver competence (n=1,110) performance questionnaire. Paired t-test was performed using SPSS program.
     Results: After implemented the clinical supervision program, nurse mentors had higher clinical supervision competence (300 vs. 215, p<0.001), and staff nurses had higher clinical competence (240 vs. 179, p<0.001) compared to previous time before implemented the program. Improved physical functioning was noted by the patients had increased score on Barthel Index (78.75 vs. 74.38, p<0.001), and the greater score on family caregiver competence (87.83 vs. 42.18, p<0.001), respectively.
     Conclusion: This study had demonstrated the effectiveness of clinical nurses supervision model on nursing care quality and patient outcomes