Factors Influencing Supportive Supervision Practice among Frontline Nurse Managers at Thika Level 5 Hospital, Kiambu County, Kenya

Abstract

BACKGROUND Supportive supervision (SS) is a process that aims at improving healthcare staff performance through the identification of knowledge and skill gaps, giving feedback and on job-training. This study aimed to assess the factors influencing SS practice among Frontline Nurse Managers at Thika Level 5 Hospital (TL5H) in Kiambu County, in Kenya. METHODOLOGY The study applied a mixed methods study design using both quantitative (analytical cross-sectional) and qualitative approaches (FGDs and KII). The study population was the Nursing Services Manager, Frontline Nurse Managers and their deputies. Quantitative data was collected using a semi-structured questionnaire and observation checklist. For qualitative data study applied purposive sampling was to recruit Frontline Nurse Managers and their deputies. Qualitative data was collected through Focused Group Discussions (FGDs) and Key informant interviews (KIIs). Quantitative analysis was done using SPSS version 25.0. Quantitative data was presented using frequency distribution tables and charts. Qualitative data were analysed using NVivo version 12 and then presented in themes. The analytical statistic was not done since there was no observed SS at Thika Level 5 Hospital (TL5H). RESULTS On observation, all wards and sections at TL5H scored below expectation on SS. From the semi-structured questionnaire, 82% of the respondents indicated SS performance as “none” per week. 64.1% of the respondents reported that they were not trained on SS and their knowledge score was AT 40%. 90% of the respondents identified staff shortage as a barrier to SS practice, 55 % as lack of time for SS and 20% identified lack of tools as a barrier to performing SS. CONCLUSION AND RECOMMENDATION Frontline Nurse Managers’ SS practice was below expectation and their knowledge of SS was marginal. Frontline Nurse Managers lacked time for SS since they also performed patient care roles due to hospital staff shortage. The study recommends the introduction of a structured SS tool, training of Frontline Nurse Managers on SS, and addressing staff shortage in hospitals.