Causal Relationship Models between Clinical Supervision, Clinical Risk Management and Nursing Outcomes Perceived by Registered Nurses in Intensive Care Units, Tertiary Care Hospitals, Northeastern Thailand

Abstract

          The objective of this research was to study the causal relationship between clinical supervision, clinical risk management and nursing outcomes according to the perception of registered nurses in intensive care units at the tertiary care hospitals in the northeastern Thailand. Two hundred and thirty–four nurses with 1 year or more of working experience in the intensive care units were included in this study by a multi–stage sampling. The research tools were the questionnaires of perception to clinical supervision, clinical risk management and nursing outcomes. The content validity was explored by the 7 experts. The reliabilities tested using the Cronbach’s alpha coefficients were 0.84, 0.96 and 0.98, respectively. Data were analyzed by the frequency, percentage, average, Chi–square test and Path analysis.

             The study revealed that the average perception of registered nurses to clinical supervision (X ̅ = 4.32, S.D. = 0.58), clinical risk management (X ̅ = 4.38, S.D. = 0.48) and nursing outcomes (X ̅ = 4.25, S.D. = 0.62) were at the highest level. The clinical supervision had both directly and indirectly positive effects on nursing outcomes with path coefficients of 0.60 and 0.30, respectively. The clinical risk management had directly positive effect on nursing outcomes with a path coefficient of 0.40. The hypothesized model was consistent with the empirical data received from study samples (Chi–square = 2.73, df = 1, p = 0.60, CFI = 1.00, GFI = 0.99, GFI = 0.99, RMSEA = 0.00). All data passed the specified criteria.

            Keywords: Causal relationship model, Clinical supervision, Clinical risk management, Nursing outcomes