Getting a ‘grip’ on supervision: A mixed method study assessing the effect of a new model for clinical supervision in mental health nursing named GRiP-S

Author Identifier

Jennifer Hamilton

Date of Award


Document Type

Thesis - ECU Access Only


Edith Cowan University

Degree Name

Doctor of Philosophy


School of Nursing and Midwifery

First Supervisor

Irene Ngune

Second Supervisor

Amanda Cole

Third Supervisor

Richard Bostwick


The Safewards model has been introduced widely across mental health services to help reduce restrictive practices. Research has identified that when implemented successfully, this effective framework reduces seclusion and physical restraint events that occur in acute mental health settings. Its effectiveness in improving how patients experience care and in enhancing safety in clinical settings is also well documented. However, certain barriers to this model’s successful implementation have been identified, including poor buy-in from staff, negative staff perceptions and insufficient training. The present study used a new approach named ‘group reflective integrated practice with Safewards (GRiP-S)’ that integrated Safewards into a clinical supervision framework in an in-patient mental health setting.

The present mixed method explanatory sequential study was conducted in two phases using a lean change feedback system methodology; the intention was to assess the effect of the GRiP-S approach by exploring how nursing staff perceive its effect on Safewards implementation, clinical supervision and clinical practice. This study was conducted in the Mental Health unit of a metropolitan private hospital in Perth, Western Australia. The Manchester Clinical Supervision Scale-26 (n=102) was used to collect quantitative data, while individual semi-structured interviews with mental health nursing staff (n=18) were used to obtain qualitative data.

The results demonstrated that the GRiP-S approach enhanced mental health nurses’ understanding and cohesive adoption of Safewards interventions; that it supported the integration of clinical supervision through positive change management; and that it confirmed previous findings regarding barriers to and enablers of mental health nurses’ engagement with clinical supervision. This study suggests that GRiP-S can have positive impacts within acute mental health settings to simultaneously provide supportive clinical supervision for nursing staff and address quality improvement in an organisation.

Recommendations established through this study’s discussion identify the role of governing agencies in using a supportive education framework to monitor, facilitate and adequately resource clinical supervision for mental health nurses. The implications of this research include the improved adoption of the Safewards model, as well as more effective clinical supervision in mental health services. This ultimately involves supportive reflection and team cohesion to help meet the needs of individual nurses, as well as improved practice outcomes and a strengthened workforce to aid organisations.



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