Hamilton Bridget, Ryu Hosu, Prematunga Roshani, Kelly Teresa, Buus Niels
Centre for Mental Health Nursing, Department of Nursing, Faculty of Medicine, Dentistry, and Health Science, University of Melbourne, Melbourne, Victoria, Australia.
School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria, Australia.
J Adv Nurs. 2025 Jun 5. doi: 10.1111/jan.17101.
Clinical supervision is claimed to benefit nurses' wellbeing, professional development and practice. However, evaluations highlight implementation challenges, and universal uptake among nurses is uncommon, which limits benefits and the quality of evaluations. This paper reports outcomes of a government policy initiative to implement clinical supervision in Victoria, Australia, with survey data generated through a program logic evaluation.
To explore nurses' perceptions of the implementation of clinical supervision, specifically addressing training adequacy, participation rates, organisational support, cultural growth and relational capacity development.
A cross-sectional survey of nursing supervisees was conducted within a program of research investigating the governmental implementation of clinical supervision.
A survey of 366 participating nurses across four separate organisations addressed the following outcome evaluation questions, arising from program logic objectives: Are nurses currently engaged in clinical supervision? What is the relationship between clinical supervision implementation and: (1) nurses' preparation for clinical supervision, (2) their experience of the organisation valuing clinical supervision and (3) valuing nurses' own wellbeing and (4) nurses' perception of their own growth in relational practice?
The findings affirm the clinical supervision implementation program by showing positive associations for the intended outcomes. Nurses reported: they had sufficient training in clinical supervision; their workplaces were experienced as supportive of clinical supervision and nurturing of the participants; and they had growth in relational ability. Each positive finding was significantly stronger for the sub-sample (65%) of study participants who were currently engaged in clinical supervision compared to those who were not.
The study foregrounds the contribution of program logic, within a multifaceted initiative and including a strong authorising environment, to the implementation of clinical supervision.
IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Implementation of clinical supervision across services can be enabled by values-congruent strategies, including high-level authorising, stakeholder objective setting, training and coalition of change agents.
This paper addresses the gap between numerous local intervention studies of clinical supervision for nurses and the lack of empirical studies informing system-wide implementation approaches. Our survey investigating implementation outcomes shows that nurses experience of the implementation was aligned to program objectives: participating nurses considered themselves effectively trained for clinical supervision and supported by the organisation, with a positive impact on their own practice. This study can assist organisations in considering large-scale implementation of clinical supervision, with a future focus on levels of uptake and impact on practice.
We have adhered to relevant EQUATOR guidelines for survey method (i.e., the CROSS checklist).
Mental Health Consumer and Carer Advisors within the Office of the Chief Mental Health Nurse, Department of Health and Human Services, Victoria, contributed to the establishment of the research evaluation objectives and related survey items. They contributed perspectives via initial project design meetings and further feedback informing the final version of the program logic.
临床督导被认为有益于护士的身心健康、专业发展和实践。然而，评估突出了实施方面的挑战，而且护士普遍接受临床督导的情况并不常见，这限制了其益处以及评估的质量。本文报告了澳大利亚维多利亚州一项实施临床督导的政府政策举措的成果，数据来自通过项目逻辑评估生成的调查。
探讨护士对临床督导实施的看法，特别关注培训是否充分、参与率、组织支持、文化成长和关系能力发展。
在一项调查政府临床督导实施情况的研究项目中，对接受督导的护士进行了横断面调查。
对四个不同组织的366名参与护士进行了调查，这些调查涉及以下源于项目逻辑目标的结果评估问题：护士目前是否参与临床督导？临床督导的实施与以下方面有何关系：（1）护士对临床督导的准备情况，（2）他们对组织重视临床督导的体验，（3）对护士自身身心健康的重视，以及（4）护士对自身在关系实践中成长的认知？
研究结果通过显示与预期结果的正相关关系，肯定了临床督导实施项目。护士报告称：他们接受了足够的临床督导培训；他们的工作场所被认为支持临床督导并有利于参与者的成长；他们在关系能力方面有所成长。与未参与临床督导的研究参与者子样本（65%）相比，目前参与临床督导的子样本在每项积极结果方面都显著更强。
该研究突出了项目逻辑在多方面举措（包括强大的授权环境）中对临床督导实施的贡献。
对专业和/或患者护理的启示：通过价值观一致的策略，包括高层授权、利益相关者目标设定、培训和变革推动者联盟，可以推动跨服务领域实施临床督导。
本文解决了众多针对护士临床督导的局部干预研究与缺乏为全系统实施方法提供信息的实证研究之间的差距。我们对实施结果的调查表明，护士对实施的体验与项目目标一致：参与的护士认为自己接受了有效的临床督导培训并得到组织的支持，这对他们自己的实践产生了积极影响。这项研究可以帮助各组织考虑大规模实施临床督导，未来重点关注接受程度和对实践的影响水平。
我们遵循了调查方法的相关EQUATOR指南（即CROSS清单）。
维多利亚州卫生与公众服务部首席精神科护士办公室的心理健康消费者和护理顾问为研究评估目标和相关调查项目的制定做出了贡献。他们通过最初的项目设计会议提供了观点，并通过进一步反馈为项目逻辑的最终版本提供了信息。
