Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK.
Department of Psychiatry, University of Cambridge, Cambridge, UK.
J Psychiatr Ment Health Nurs. 2018 Apr;25(3):145-156. doi: 10.1111/jpm.12447. Epub 2018 Jan 9.
WHAT IS KNOWN ON THE SUBJECT?: Regular and effective clinical supervision for mental health nurses and healthcare assistants (HCAs) is an important tool in helping to reduce stress and burnout, and in ensuring safe, effective and high-quality mental health care. Previous studies of clinical supervision within secure mental health environments have found both a low availability of clinical supervision, and a low level of staff acceptance of its value, particularly for HCAs. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: In previous studies, the understanding shown by HCAs and nurses around the benefits of clinical supervision may have been limited by the methods used. This study was specifically designed to help them best express their views. In contrast to previous studies, both nurses and HCAs showed a good understanding of the function and value of clinical supervision. Significant improvements in the experience of, and access to, clinical supervision for nurses and HCAs working in secure mental health services may be achieved by raising staff awareness, demonstrating organizational support and increasing monitoring of clinical supervision. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Organizations should consider reviewing their approach to supervision to include raising staff awareness, multidisciplinary supervision, group supervision, and recording and tracking of supervision rates. Organizations should be mindful of the need to provide effective clinical supervision to HCAs as well as nurses.
Introduction Studies have found a low availability and appreciation of clinical supervision, especially for healthcare assistants (HCAs). Qualitative research is needed to further understand this. Aims Increase understanding of nurses' and HCAs' experiences of, and access to, clinical supervision. Identify nurses' and HCAs' perceptions of the value and function of clinical supervision. Assess how interventions affect staff's experiences of clinical supervision. Methods In 2013, HCAs and nurses in a secure adolescent service were surveyed about clinical supervision. Forty-nine HCAs and 20 nurses responded. In 2014, interventions to facilitate supervision were introduced. In 2016, the study was repeated. Forty HCAs and 30 nurses responded. Responses were analysed using a mixed methods approach. Results Significantly more HCAs found supervision to be a positive experience in 2016, and both nurses and HCAs reported significantly fewer challenges in accessing supervision. HCAs and nurses understood the value of clinical supervision. Discussion Significant improvements in the experience of clinical supervision were achieved following increased staff awareness, multidisciplinary and group supervision, and recording supervision rates. HCAs and nurses understood the consequences of inadequate supervision. Implications for practice Organizations could adopt the interventions to facilitate clinical supervision. Supervision should not be overlooked for HCAs.
增加对护士和医护辅助人员（HCAs）体验和获得临床监督的理解。确定护士和 HCAs 对临床监督的价值和功能的看法。评估干预措施如何影响员工的临床监督体验。
2013 年，对一个安全青少年服务中心的 HCAs 和护士进行了临床监督调查。49 名 HCAs 和 20 名护士做出了回应。2014 年，引入了促进监督的干预措施。2016 年，重复了这项研究。40 名 HCAs 和 30 名护士做出了回应。使用混合方法分析了回应。
在 2016 年，更多的 HCAs 发现监督是一种积极的体验，护士和 HCAs 报告在获得监督方面的挑战明显减少。HCAs 和护士理解临床监督的价值。
在提高员工意识、多学科和小组监督以及记录监督率之后，临床监督的体验有了显著的改善。HCAs 和护士理解监督不足的后果。
组织可以采用这些干预措施来促进临床监督。不应忽视 HCAs 的监督。
