Developing Model of Clinical Nursing Supervision Nurse Departments, Naduang Hospital

Abstract

This study aimed at developing clinical nursing supervision in the Nursing Group at Naduang Hospital. The participants were 15 supervisors in the Out-patient Department, Accident and Emergency Department, Labor room and the In-patient ward (August 2018 to May 2019). The researcher used questionnaires of knowledge and attitude for collecting objective data. For collecting subjective data, the researcher used a focus group, in-depth-interview, an observation based on a framework of Kemmis & Mc Taggart (1991). The two cycles of four steps such as Planning, Action, Observation, and Reflection were conducted until results reaching objectives. 

The first cycle (August – December 2018) found that 1) The clinical incidents in the fiscal years of 2016 and 2017 found that the medium-level clinical incidents need to dangerous temporary to patients by 11 and 9 incidents respectively. The high incidents led to dangerous permanent to patients by 3 and 3 clinical incidents. 2) For the participants had high scores level in knowledge of meaning and prioritization but only techniques having at a low score level. The participants had a good attitude toward nursing supervision in the area of benefits and promotion competency. However, they only understood that supervision wastes time and not different from nursing administration at a high level. 3) Lack of a clear supervision model led to supervision model education, therefore, they selected the TGROW supervision model (October – November 2018).  According to the findings after finishing 1 cycle, the researcher found that medium-level incidents dropped to 3 incident and high incidents at 1 incident. For reflection, the researcher found that the supervision inwards lacked knowledge in important diseases and using medical equipment at high risk so that the supervisors of Accident and Emergency Department became supervisor instead of the old one. For cycle 2 (January 2018- April 2019), participants used a supervision model from both departments to apply for In- patient wards. The results found that the medium-level incidents dropped from 3 to 0 and high-level incidents dropped from 1 to 0. The health team in the hospital used the TGROW nursing supervision model to be a framework to construct learning knowledge. The participants had the knowledge, understanding, and better attitudes because the participants believed nursing supervision to be the same issue as nursing administration. Therefore, the TGROW nursing supervision model should be implemented continually.