Supervisão clínica em enfermagem

: contributos para a conceção de um programa em contexto de cuidados de saúde primários

Abstract

Clinical supervision (CS) in nursing is a process that facilitates professional development that has been strategically adopted by different health policies in order to ensure the quality and safety of care. The evidence suggests an improvement in the quality of care with the implementation of the CS, however, research that demonstrates its impact in improving the quality of the nurses' professional practice and in the direct results in the clients are meager. In this sense, the present research aims to contribute to the design of a CS program that is useful and appropriate to the Primary Health Care context and constitutes a contribution to the improvement of the quality of the nurses’ professional exercise. The research was anchored in the constructivist paradigm. Fieldwork included four phases: access to the field and definition of data collection and processing strategies; identification of the supervision in use and exposed, definition of the "problem" and opportunities for development; change planning and definition of CS program; and results presentation. We used qualitative and quantitative strategies for data collection, semi-structured interview and questionnaire, respectively, with the objective of triangulation and consolidation of the "emerging". A total of 42 nurses from Alto Tâmega and Barroso Health Centers Group (ACeS) participated in the interviews, 85.7% female. In the data collection through questionnaires, participated 44 nurses from the same context, 86.4% female. Three key areas emerged from the analysis: the concepts of clinical supervision in nursing, CS in use and the proposed. From these, the central elements for the CS program and the strategies and methodologies appropriate to their implementation were defined. The results obtained allowed to conclude from the existence of supervision practices in use, some of them intrinsic to the CS. Participants exposed the implementation of CS policies focused on formative, normative and support functions of supervision. The program to be implemented delimits the elements that preside over the CS: applicability and target audience, conceptual foundations, philosophy, culture, purpose, objectives, scopes, roles and responsibilities of the actors, education, training and support of supervisors, maintenance, confidentiality and record keeping, monitoring and evaluation of the CS. The incorporation of CS policies in the context of Primary Health Care is a challenge, in particular with regard to operationalization, however, their impact on the quality of the professional practice can legitimize the investment in their adoption.

Date of Award	31 Jul 2019
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Rui Canário (Supervisor) & Filipe Pereira (Co-Supervisor)