Report on the Evaluation of the Implementation of Peer Group Clinical Supervision for Nurses in the HSE South (Cork and Kerry)

Peer Group Clinical Supervision (PGCS) is a form of Clinical Supervision whereby two or more practitioners engage in a supervision or consultation process to improve their professional practice. It is a process of supporting healthcare professionals to develop their practice through regular discussion with experienced and knowledgeable colleagues. In response to the increasing demands for quality and safe healthcare outcomes, the Nursing and Midwifery Planning and Development Unit (NMPDU) for Cork and Kerry recognised the potential for Clinical Supervision to support nurses in clinical practice. In September 2018, the NMPDU embarked on a pilot project to evaluate the effectiveness of a supervisor-led PGCS programme, a form of group Clinical Supervision, for nurses in the region. The overall aim of this commissioned report is to report the findings of a mixed-methods research evaluation of PGCS for nurses in Cork and Kerry. There is limited empirical evidence regarding the impact of PGCS on nurses and midwives (Borders, 2012) and as such, two studies (one qualitative and one quantitative) were designed to measure specific outcomes, including nurse supervisees’ overall experiences of participating in PGCS, as well as differences in their understanding of Clinical Supervision and their perceptions of organisational functioning before and after engaging in PGCS. The perceptions of clinical supervisors and senior line managers and their experiences of the PGCS process were also captured through the qualitative arm of the research1. The NMPDU supports nurses and midwives in Ireland to undertake post-registration education and ensure continuing professional development. In response to requests from services, the NMPDU recognised the potential for Clinical Supervision to support nurses in clinical practice. The NMPDU convened a steering group (Appendix 1) of representatives from nursing and midwifery services, advanced practice, CNMEs, ONMSD and HEI to oversee the development and implementation of this project. PGCS was offered to all nursing and midwifery services in Cork and Kerry and 10 groups of staff across 9 sites agreed to participate in this pilot project. Monthly one-hour PGCS sessions were facilitated between September 2018 and August 2019. Each PGCS group comprised of four to six nurses. Protected time within the working day was allocated for most PGCS sessions which were held in private and quiet venues. PGCS discussions revolved around: (1) enhancing the quality of work practices; (2) exploring decision-making processes and their impact on patients; (3) seeking and receiving information; (4) expressing and exploring issues arising through work practices; (5) being challenged in a supportive manner; and (6) receiving support and feedback. Each peer group consisted of staff of the same or similar grade, with four to six participants in each group. In total, 57 nurses, across the nine sites, commenced the PGCS project. Prior to the commencement of the project, nurse supervisees were informed verbally that the outcomes of the project were being evaluated using research methods. They were informed that they were not obliged to partake in either of the research studies and that this would not affect their participation in the PGCS sessions. The qualitative study utilised focus groups and individual interviews. All PGCS session supervisees, as well as supervisees’ line managers and the supervisors who facilitated the PGCS sessions, were eligible to participate, with separate focus group/individual interviews held for each of these three groups. There was a total of 27 participants in this study (18 PGCS nurse supervisees, five line managers, and four clinical supervisors). The quantitative study used a pre-post design and all nurse supervisees who attended the PGCS sessions were eligible to participate by completing two questionnaires – the first prior to the commencement of the first PGCS session and the second following the completion of the final PGCS session (12 months later). A total of 51 supervisees participated in the quantitative study.