The Nurse-Family Partnership (NFP) is an evidence-based public health initiative targeted to young, pregnant, first-time mothers impacted by social and economic disadvantage. This study is part of an embedded qualitative process evaluation from a larger cluster RCT trial. The purpose of this study was to understand NFP supervisor roles, responsibilities, and experiences associated with the uptake of a new IPV intervention by nurse home visitor into existing NFP practice. / The Nurse-Family Partnership® (NFP) is a home visitation program for young pregnant and first-time mothers affected by social and economic disadvantage. In response to intimate partner violence (IPV) experienced by women and children involved in the program, a nursing intervention was developed to support nurse home visitors identify and respond to IPV. Within each participating NFP team, supervisors were accountable for facilitating the implementation process of the IPV intervention for uptake into nurse home visitor practice. To understand the functions of NFP supervisors involved with the facilitation of the implementation process for the IPV intervention, an interpretive description approach was utilized involving primary data collection from interviews with 11 supervisors and 2 managers, and triangulated with secondary data from 7 focus groups (n=35 nurses). From this analysis, an NFP supervision framework was developed that included 4 domains, 7 roles, 3 sub-roles and multiple responsibilities. Supervision was found to involve roles and sub-roles functioning in oversight of implementation and others that functioned in the direct implementation of the IPV intervention, forming levels of supervision, and creating a hierarchy. A comprehensive appreciation of NFP supervisor domains, roles, sub-roles and responsibilities enacted during the implementation process is important to help identify the best alignment of human resources, recognize how the NFP can best support supervisors, and to champion achievement of current and future innovation implementation goals. Recommendations of support for supervisors include facilitating educational opportunities, creating transparency of the implementation process, developing a quality improvement strategy, providing supervisor mentorship, improving standardization, and recognizing the competing NFP priorities for supervisors and nurse home visitors. / Thesis / Master of Science (MSc) / The Nurse-Family Partnership® (NFP) is a home visitation program targeted to young mothers, pregnant with their first child. To support nurse home visitors identify and respond to intimate partner violence (IPV) experienced by NFP mothers and children, an IPV intervention was developed. Within the NFP implementing agencies, supervisors were instrumental in ensuring the IPV intervention was delivered as intended, forming what is known as the implementation process. This qualitative interpretive descriptive study involved interviews with 11 supervisors and 2 managers, as well as a secondary analysis of 7 focus groups (n=35 nurses) to understand and describe the roles and responsibilities supervisors had within this process. From the analysis of these data, an NFP supervision framework was developed that included articulation of 4 domains, 7 roles, 7 sub-roles and multiple responsibilities affiliated with this position. This framework offers a new language for supervision which may become a first step to better understanding, communicating, and developing supervision in home visitation, and in particular, articulating the functions supervisors are required to lead when faced with the responsibility for implementing a new innovation within their program. It is important to understand NFP supervisor functions of the implementation process to enable NFP strategies that will best support supervisors, ensure responsibilities belong to the right person, and meet implementation goals when adopting evidence into NFP nurse home visiting practice.
| Identifer | oai:union.ndltd.org:mcmaster.ca/oai:macsphere.mcmaster.ca:11375/25731 |
| Date | January 2020 |
| Creators | Stone, Cynthia |
| Contributors | Jack, Susan, Nursing |
| Source Sets | McMaster University |
| Language | English |
| Detected Language | English |
| Type | Thesis |
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