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

Abstract

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.

References
[1] Abualrub, R.F. & Al-Zaru, I.M. (2008). Job stress, recognition, job performance and intention to stay at work among Jordanian Hospital nurses. Journal of Nursing Management, 16, 227-236.

[2] Aghakhani, N., Nia, H.S., Rahbar, H., & Behesti, Z. (2012). Nurses’ attitude to patient educational hospitals of Urmia University of Medical Science. Iranian Journal of Nursing and Midwifery Research, 17, 12-15.

[3] Arwani. & Supriyanto, H. (2004). Manajemen bangsal keperawatan (Nursing ward management). Jakarta: EGC.

[4] Bachtiar, A., Hafizzurachman, & Trisnantoro, L. (2011). Beberapa faktor yang mempengaruhi kinerja perawat dalam menjalankan kebijakan keperawatan di rumah sakit umum daerah (Several factors affecting nurse performance in implementing the nursing policies in regional public hospitals). Journal Indonesia Medical Association, 61(10), 387-393.

[5] Barber, L., Paul, J., & Harimurti, P. (2007). The contribution of human resources for health to the quality of care in Indonesia. Health Affairs, 26(3), 367-379.

[6] Berg, A. & Hallberg, I.R. (1999). Effect of systematic clinical supervision on psychiatric nurses’ sense of coherence, creativity, work-related strain, job satisfaction and view of the effect from clinical supervision: Pre – post design. Journal of Psychiatric and Mental Health Nursing, 6, 371–381.

[7] Brunero, S., & Stein-Parbury, J. (2008). The effectiveness of clinical supervision in nursing: An evidenced based literature review. Australian Journal of Advanced Nursing, 25(3), 86-94.

[8] Dewi, R., Yetti, K., & Ayubi, D. (2008). Supervisi kepala ruangan berdasarkan kelengkapan pendokumentasian asuhan keperawatan (Head nurse supervision based on comprehensiveness of nursing documentation). http://Journal.ui.ac.id. Downloaded 26 January 2014.

[9] Dochterman, J.M., & Bulechek, G.M. (2004). Nursing interventions classification (NIC). St. Louis Missouri: Mosby.

[10] Finkelman, A.W. (2006). Leadership and management in nursing. New Jersey: Pearson Prentice Hall.

[11] Gaberson, K.B., & Oermann, M.H. (2007). Clinical teaching strategies in nursing, New York: Springer Publishing Company.

[12] Gillies, D. (1994). Nursing management system approach. Chicago: Lippincot Company.

[13] Greenslade, J.H. & Jimmieson, N.L. (2007). Distinguishing between task and contextual performance for nurses: Development of a job performance skill. Journal of Advanced Nursing, 58, 602-6011.

[14] Hadju, L., Hamzah, A. & Hadju, V. (2010). Hubungan karakteristik individu dan organisasi terhadap kinerja asuhan keperawatan di unit rawat inap RSUD Kabupaten Muna. (Correlation between individual and organization characteristics and nursing care performance in the inpatient units of the regional public hospital in Muna Regency). Jurnal MKMI, 6(2), 108-112.

[15] Hasmoko, E.V. (2008). Analisis faktor-faktor yang mempengaruhi kinerja klinis perawat berdasarkan penerapan sistem pengembangan manajemen kinerja klinis (SPMKK) di ruang rawat inap Rumah Sakit Panti Wilasa Citarum Semarang Tahun 2008 (Analysis of factors affecting nurses’ clinical performance based on the implementation of clinical performance management development system in the inpatient wards of Panti Wilasa Hospital, Citarum, Semarang, in 2008). Thesis, Semarang: Universitas Diponegoro.

[16] Kaija, A.S., Riina, H. & Hyrkas, K. (2006). Efficacy of clinical supervision influence on job satisfaction, burn out and quality of care. Journal of Advanced Nursing, 55, 521-535.

[17] Keliat, B.A., & Akemat. (2007). Model praktik keperawatan profesional jiwa (A model of professional mental nursing practice). Jakarta: Penerbit Buku Kedokteran EGC.

[18] Langlois, J.P. (2004). Teaching at the bed side. http://portal.utpa.edu. Downloaded 26 January 2014.

[19] Leana, R.U., Minnaar, A., Simpson, B. & Reid, S. (2005). The effect of two models of supervision on selected outcomes. Journal of Nursing Scholarship, 37, 282–288.

[20] Lynch, L., Hancox, K., Happell, B., & Parker, J. (2008). Clinical supervision for nurses. United Kingdom: Wiley- Blackwell Publication.

[21] Ministry of Health. (2011). Standar akreditasi rumah sakit (Hospital Accreditation Standards). Jakarta: Dirjen Bina Upaya Kesehatan dan Komite Akreditasi Rumah Sakit.

[22] Ministry of Health. (2012). Data dan informasi update dan realtime tentang keadaan rumah sakit di seluruh Indonesia. (Updated and real-time data and information about hospitals in Indonesia) http://20270.136.52/rsonline/repport, Downloaded 17 December 2012.

[23] Ministry of Health. (2014). Perawat mendominasi tenaga kesehatan. http://www.depkes.go.id/index. php, Downloaded 23 May 2014.

[24] Park, M.P. (2005). Nurses’ perception of performance and responsibility of patient education. Journal of Korean Academy of Nursing, 35(8), 1514-1521.

[25] Perry, A.G. & Potter, P.A. (2005). Fundamental Keperawatan (Fundamentals of nursing). Jakarta: EGC Penerbit buku kedokteran.

[26] Saljan, M. (2005). Pengaruh pelatihan supervisi terhadap peningkatan kinerja perawat di ruang rawat inap Rumah Sakit Islam Jakarta Pondok Kopi Jakarta Timur (The influence of supervision training on nurse performance improvement in the inpatient wards of Jakarta Islamic Hospital, Pondok Kopi, East Jakarta). Thesis. Jakarta: Universitas Indonesia.

[27] Skilbeck, J., & Payne, S. (2003). Emotional support and the role of clinical nurse specialists in palliative Care. Journal of Advanced Nursing, 43(5), 521–530.

[28] Smeltzer, S.C., & Bare, B. (2004). Medical surgical nursing. Philadelphia: Lippincott Williams & Wilkins.

[29] Sumiyati, A. (2006). Analisis faktor-faktor yang berhubungan dengan kinerja kepala ruang rawat inap di Rumah Sakit Dokter Kariadi Semarang (Analysis of factors related to the performance of head nurse in Doctor Kariadi Hospital, Semarang). Thesis, Semarang: Universitas Diponegoro.

[30] Taylor, C., Lillis, S. & LeMone, P. (2005). Fundamentals of nursing: The art and science of nursing care. Philadelphia: J.B. Lippincott Company.

[31] Usta, Y.Y. (2012). Importance of social support in cancer patients. Asian Pacific Journal of Cancer Prevention, 13, 3569-3572.

[32] Wilkes, L., Beale, B., Cole, R.. & Tracy, S. (1999). Supportive care for woman with breast cancer: Australian nurses’ perspective. Nursing Health Sciences, 1, 71-76.