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Abstract(s)
A supervisão clínica (SC) em enfermagem consiste num processo facilitador do desenvolvimento profissional que tem vindo a ser estratégicamente adotado por diferentes políticas de saúde, no sentido de assegurar a qualidade e segurança dos cuidados. A evidência sugere a melhoria da qualidade dos cuidados com a implementação da SC, contudo, é escassa a investigação que demonstre o seu impacte na melhoria da qualidade do exercício profissional dos enfermeiros e nos resultados diretos nos clientes. Neste sentido, a presente investigação tem por finalidade contribuir para a conceção de um programa de SC que se mostre útil e adequado ao contexto dos Cuidados de Saúde Primários (CSP) e se constitua como contributo para a melhoria da qualidade do exercício profissional dos enfermeiros. A investigação radicou no paradigma construtivista. O trabalho de campo integrou quatro fases: acesso ao campo e definição das estratégias de recolha e tratamento dos dados; identificação da supervisão em uso e exposta, definição do “problema” e oportunidades de desenvolvimento; planeamento da mudança e definição do programa de SC; e apresentação dos resultados. Utilizámos estratégias qualitativas e quantitativas para recolha de dados, entrevista semi- estruturada e questionário, respetivamente, com o objetivo de triangulação e consolidação do “emergente”. Participaram nas entrevistas 42 enfermeiros do Agrupamento de Centros de Saúde (ACeS) do Alto Tâmega e Barroso, 85,7% do sexo feminino. Na recolha de dados através dos questionários, participaram 44 enfermeiros, do mesmo contexto, 86,4% do sexo feminino. Da análise emergiram três grandes domínios: as conceções sobre a supervisão clínica em enfermagem, a SC em uso e a SC proposta. A partir destes definiram-se os elementos centrais para o programa de SC e delimitaram-se as estratégias e metodologias adequadas à sua implementação. Os resultados obtidos permitiram concluir da existência de práticas de supervisão em uso, algumas destas intrínsecas à SC. Os participantes expuseram a implementação de políticas de SC centradas nas funções formativa, normativa e de suporte. O programa a implementar delimita os elementos que presidem à SC: aplicabilidade e público- alvo, fundamentos concetuais, filosofia, cultura, finalidade, objetivos, âmbitos, funções e responsabilidades dos intervenientes, formação, treino e apoio dos supervisores, a manutenção, confidencialidade e segurança dos registos, monitorização e avaliação da SC. A incorporação de políticas de SC no contexto dos CSP constitui um desafio, nomeadamente, no que respeita à operacionalização, contudo, o seu impacte na qualidade do exercício profissional pode legitimar o investimento na sua adoção.
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.
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.
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Keywords
Programa de supervisão clínica em enfermagem Supervisão de enfermagem Exercício profissional Garantia da qualidade Clinical supervision program in nursing Nursing supervisory Professional exercise Quality assurance