The Effectiveness of Educative, Supportive, and Administrative Cycle (ESA-C) Clinical Supervision Model in Improving the Performance of Public Hospital Nurses

Consistent supervision affects nurse performance, but in its implementation in nursing care in Indonesia, supervision tends to be more monitoring in nature and lacking the efforts of educating, motivating, training, and directing. The clinical supervision model of Educative, Supportive, and Administrative Cycle (ESA-C) is made to increase the positive value of supervision. The model is synthesized from Kadushin’s and Proctor’ supervision models integrated with Peplau’s interpersonal relationship theory and Watson’s carative factors. The research aims to test the effectiveness of ESA-C clinical supervision model in improving nurse performance using the quasi-experimental design of two group pre-post-tests. Two hospitals were randomly selected from the five public hospitals as the research location. The sample consisted of 90 nurses and 270 patients, taken randomly and purposively, respectively. The results indicate that the ESA-C clinical supervision model was able to significantly improve the nurses’ performance (p-value < 0.05) in the dimensions of task performance: technical skills improved by 2%, patient education 9%, emotional support to patients 14%; and contextual performance: assistance to patients and families improved by 21%. It is recommended that the model be used in nursing care, especially in hospitals, in an attempt of improving nurse performance in providing nursing care to patients.

A VARIETY OF TEACHING-LEARNING STRATEGIES TO IMPROVE THE CARING BEHAVIOR OF NURSING STUDENTS

Background: Caring is the essence of nursing that is believed vital in improving the health and well-being of patients and in facilitating health promotion. Nursing education has a fundamental role in shaping a positive student’s caring behavior.Objective: This study identified the caring behavior of the final-year nursing students after completing a critical care nursing course unit by implementing assorted teaching-learning strategies.Methods: This study was a descriptive research using a comparative design. Samples were recruited from a group of 152 final-year students using a random sampling technique (n=76). Data were collected using a valid and reliable Indonesian caring instrument consisting of 32 items based on Watson’s ten carative factors. Data were analyzed using descriptive statistics by calculating mean scores of students’ caring behavior. A paired t test was performed to evaluate the difference between caring behavior before and after completion of the course unit involving a diverse teaching learning strategies, such as face-to-face lectures in the class, quizzes and practicums, facilitated small group case-based discussions, and expert reviews.Results: Results showed that more than half of the students had negative caring behavior before (59.22%) and after (54.55%) participating in learning process. There was also a barely statistical unsignificance in the change of caring behavior following the course unit that involved various learning strategies (p value = 0.276). Further analyses of the 10 carative factors revealed that there was a significant change in transpersonal teaching-learning, provision for a supportive, protective, and/or corrective mental, physical, sociocultural, and spiritual environment, and spiritual environment and existential-phenomenological spiritual forces (improved, p value <0.05).Conclusions: Student-centered learning is a good approach to enhance the students’ critical thinking skills. However, in implementing the approach, there is a need to reevaluate appropriate method so as to simultaneously develop students’ critical thinking skills, caring behavior, and empathy.

The concept of Watson’s carative factors in nursing and their (dis)harmony with patient satisfaction

BackgroundConstant reviews of the caring behavior of nurses and patient satisfaction help to improve the quality of nursing. The aim of our research was to explore relationships between the level of nursing education, the perception of nurses and nursing assistants of Watson’s carative factors, and patient satisfaction.MethodsA questionnaire survey using a convenience sample of 1,098 members of nursing teams and a purposive sample of 1,123 patients in four health care institutions in Slovenia was conducted in August 2012. A demographic questionnaire and the Caring Nurse-Patient Interactions Scale (nurse version) were delivered to the nurses. A Hospital Consumer Assessment of Health Plans Survey was delivered to discharged patients. Data were analyzed using descriptive and inferential statistics.ResultsCarative factor sensibility was related to the level of nursing education. Patients were satisfied with the care received from nurses, nursing assistants and hospitals, although we found differences between the perceptions of nurses and nursing assistants of carative factors and patient satisfaction. By comparing only the perceptions of nurses and nursing assistants of carative factors in health care institutions, differences were found for seven out of ten carative factors.DiscussionWe did not find major significant differences between carative factors and level of nurse education, except in one carative factor. Differences in perceptions of carative factors between health care institutions are probably the result of different institutional factors. The results can be of great benefit to nurse administrators and educators, indicating the factors that must be taken into account for enhancing patient satisfaction. Emphasis on caring theories should be placed in nursing education and their application in nursing practice.

Caring in Pediatric Emergency Nursing

An environment committed to providing family-centered care to children must be aware of the nurse caring behaviors important to parents of children. This descriptive study assessed the psychometrics of a revised version of the Caring Behaviors Assessment (CBA) and examined nurse caring behaviors identified as important to the parents of pediatric patients in a pediatric emergency department. Jean Watson’s theory of human caring provided the study’s theoretical underpinnings. The instrument psychometrics was determined through an index of content validity (CVI) and internal consistency reliability. The instrument was determined to be valid (CVI = 3.75) and reliable (Cronbach’s alpha = .971). The revised instrument was completed by a stratified, systematic random sample of 300 parents of pediatric emergency patients. Participants rated the importance of each item for making the child feel cared for by nurses. Individual survey item means were computed. Items with the highest means represented the most important nurse caring behaviors. Leading nurse caring behaviors centered on carative factors of “human needs assistance” and “sensitivity to self and others.” Nearly all nurse caring behaviors were important to the parents of pediatric patients, although some behaviors were not priority. It is important for nurses to provide family-centered care in a way that demonstrates nurse caring.

An Exploration of the Nature of Caring Relationships in the Writings of Florence Nightingale

The purpose of this qualitative, historical field study was to identify the nature and attributes of caring relationships as depicted in the writings of Florence Nightingale. Latent content analysis was the methodology used for the discovery and analysis of words, ideas, and themes from selected Nightingale works. Five themes were identified that represented a caring relationship: attend to, attention to, nurture, competent, and genuine. These themes are congruent with Nightingale’s threefold concept of nursing. Watson’s carative factors were used to cross-validate the results. The findings of this study indicate that the phenomenon of caring relationships in nursing has been a part of our professional language since Victorian times. Historical research provides a sense of connectedness to nursing’s past and contributes to the ongoing education of nurses and further development of the nursing profession.