An exploration of the supervisory ward sister role. v2
Research type
Research Study
Full title
An exploration of the supervisory ward sister role
IRAS ID
259488
Contact name
Alistair Hewison
Contact email
Clinicaltrials.gov Identifier
ERN_18-1018., University ethics application
Duration of Study in the UK
1 years, 2 months, 31 days
Research summary
Research Summary
Over recent years a number of reports have examined poor patient care in hospitals. These reports identified that poor ward leadership may contribute to this lack of care and more specifically poor leadership from the ward sister. To address this leadership issue, it has been suggested introducing a new role - the Supervisory Ward Sister may help. The focus of this role is to change the ward sister role, so they are not included in ward nursing establishment numbers to deliver care, but to use their time to lead, supervise and monitor standards.Although the idea of the supervisory ward sister role has been received well in England it is not known how widely it has been adopted or whether providing more leadership time is enhancing the role of the ward sister. This is made more difficult because there is also a lack of clarity concerning the role and how this role is performed.
This study plans to identify how well the supervisory ward sister role has been adopted in England and how this is defined by Directors of Nursing in hospitals. It aims also to examine the leadership experiences of supervisory ward sisters through interviews to understand their perceptions of what the role consists of. Finally, using a group of participants that interact with wards sisters, including service users, staff nurses, ward sisters, Matrons and Directors of nursing, the study will try to use the findings of the ward sister interviews to reach a consensus of what this leadership role consists of and how this can be defined.
It is hoped, once the supervisory ward sister leadership role has been clearly understood and the positive elements identified, that this work will encourage NHS Trusts to introduce the role to a greater number of areas.
Summary of Results
The aim of this study was to explore the role of the supervisory ward sister, a role which involves the ward sister having time designated in the staffing rota to focus on ward management rather having to undertake direct clinical care. The purpose of the role is to enable the ward sister to concentrate on managing and leading the ward staff to improve the quality of nursing care provided for patients.
The purpose of the study was to find out which acute Trusts in England had adopted the Supervisory Ward Sister model by means of a national survey, and to understand the role in more depth by interviewing ward sisters who were supervisory. The study design also incorporated recruitment of a panel of experts to determine what the role should consist of. This was to be achieved through application of an innovative eDelphi technique whereby the expert panel would meet regularly, using an on-line platform, to rank statements about the role until agreement was reached on which were its essential components.Unfortunately, the data collection phase of the study coincided with the Covid 19 Pandemic resulting on in restrictions being imposed on access to practice areas, and the re-deployment of personnel in response to the demands on the NHS. This meant it was not possible to recruit participants to the study in sufficient numbers, despite extensive effort to do so. The response rate for the national survey was 19% and indicated there was some take up of the supervisory ward sister role. Of the 26 responses received 58% of the trusts had ward sisters in all areas but only 42% had supervisory ward sisters for the full 37.5 hours per week. The most common allocation of supervisory hours was between 1 – 3 days a week. Where supervisory ward sisters were in place, they were at Band 7. This poor response rate meant that only a non-representative description of the national picture could be produced.
For Phase 2 of the study, it was not possible to recruit any ward sisters, for the reasons noted above. In view of this the study was terminated before the completion of Phase 2 or commencement of Phase 3.
REC name
London - Fulham Research Ethics Committee
REC reference
19/LO/1984
Date of REC Opinion
18 Feb 2020
REC opinion
Further Information Favourable Opinion