Mental Health Nurses' Perception of Clinical Supervision Implementation Mapped Against a Program Logic: A Survey Study

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. AIM: To explore nurses' perceptions of the implementation of clinical supervision, specifically addressing training adequacy, participation rates, organisational support, cultural growth and relational capacity development. DESIGN: A cross-sectional survey of nursing supervisees was conducted within a program of research investigating the governmental implementation of clinical supervision. METHOD: 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? RESULTS: 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. CONCLUSION: 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. IMPACT: 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. REPORTING METHOD: We have adhered to relevant EQUATOR guidelines for survey method (i.e., the CROSS checklist). PATIENT OR PUBLIC CONTRIBUTION: 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.