Is it possible to strengthen psychiatric nursing staff's clinical supervision? RCT of a meta-supervision intervention.

Abstract

To test the effects of a meta-supervision intervention in terms of participation, effectiveness and benefits of clinical supervision of psychiatric nursing staff. Clinical supervision is regarded as a central component in developing mental health nursing practices, but the evidence supporting positive outcomes of clinical supervision in psychiatric nursing is not convincing. The study was designed as a randomized controlled trial. All permanently employed nursing staff members at three general psychiatric wards at a Danish university hospital (n=83) were allocated to either an intervention group (n=40) receiving the meta-supervision in addition to attending usual supervision or to a control group (n=43) attending usual supervision. Self-reported questionnaire measures of clinical supervision effectiveness and benefits were collected at base line in January 2012 and at follow-up completed in February 2013. In addition, a prospective registration of clinical supervision participation was carried out over 3months subsequent to the intervention. The main result was that it was possible to motivate staff in the intervention group to participate significantly more frequently in sessions of the ongoing supervision compared with the control group. However, more frequent participation was not reflected in the experienced effectiveness of the clinical supervision or in the general formative or restorative benefits. The intervention had a positive effect on individuals or wards already actively engaged in clinical supervision, which suggested that individuals and wards without well-established supervision practices may require more comprehensive interventions targeting individual and organizational barriers to clinical supervision.