The development of a clinical supervision model for severe sepsis patients
Keywords:
development, clinical supervision model, register nurse, severe sepsis patientsAbstract
This research and development study aimed to develop a clinical supervision model for severe sepsis patients by using Proctor’s model and to evaluate the outcomes of this developed model. There were 5 steps in study process; 1) survey of clinical supervision problems, 2) development of a clinical supervision model for severe sepsis patients, 3) pilot study of the clinical supervision model in clinical practices, 4) evaluation of the clinical supervision model 5) use of the clinical supervision model in the institution. The samples were 22 head nurses, 327 registered nurses, and medical records of severe sepsis patients before and after the development of the clinical supervision model, 73 patients’ records in each group. The research tools were 1) Focus group question, 2) clinical supervision model utilization questionnaires, 2) nursing knowledge tests, 3) records of care process and outcomes.
The results showed that the developed clinical supervision model to solve the problems and obstacle consisted of identifying roles and functions of supervisor, identifying issues of clinical supervision, collaboration between head nurse and staff nurses in planning and doing clinical supervision, including evaluation of clinical supervision. After development of a clinical supervision model for severe sepsis patients, the head nurses had improved knowledge and attitude on clinical supervision. The registered nurses had increased nursing care knowledge for severe sepsis patients after clinical supervision model implementation. There were significantly increased in rate of detection patient sign changes, rate of blood collection for hemoculture before antimicrobial administration, rate of antimicrobial administration within 1 hour, and rate of adequate tissue perfusion within 6 hours (p<.01).
Nurse administrators should continuously evaluate outcomes in caring of severe sepsis patients, and further develop clinical supervision models for other groups of patients.
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