Where resources are limited, it is better to concentrate on providing clinical supervision to more junior grades of nurses as a valued form of support during their early years as qualified practitioners.

Clinical supervision and support for nurses: an evaluation study Aim. To assess the effects of clinical supervision and informal support on qualified nurses. Rationale. Earlier small‐scale research studies have provided conflicting evidence about the impact of clinical supervision, hence the need for this larger‐scale study. Design. Survey design drawing on an opportunity sample of 211 qualified nurses from 11 randomly selected hospital and community NHS Trusts in one region in England. Quantitative data collection used the Maslach Burnout Inventory (MBI) and the Nursing in Context Questionnaire (NICQ), while qualitative data were based on written critical incidents. The analysis compared supervized with unsupervized nurses. Findings. The critical incident analysis revealed that supervized nurses continued to use informal support networks as well as their supervision sessions to discuss clinical issues. The MBI found no significant differences in levels of burnout between supervized and unsupervized nurses. However, the NCIQ detected some statistically significant differences, with supervized nurses reporting a more listening and supportive management, coping better at work and feeling that they had better access to support than unsupervized nurses. Closer analysis found that this positive finding was particularly strong among the more junior supervized nurses. Conclusion. Where resources are limited, it is better to concentrate on providing clinical supervision to more junior grades of nurses as a valued form of support during their early years as qualified practitioners.

The primary prevention of child abuse is both a clinical and political priority. Home visiting programmes consisting of structured visits by a professional over an extended period of time during the perinatal period 'Structured visits by a professional over an extended period of time'have been identified in a number of studies as being a potentially effective means of achieving this. The use of professionally delivered home visiting programmes in the UK to date, however, has been limited. This paper describes the development of an innovative, primary care-based home visiting service, which is aimed at the primary prevention of maltreatment, abuse and neglect and the promotion of positive parenting and secure attachment. The paper provides a description of the rationale and policy context for the new service and an account of its development, with particular emphasis on the aim of working 'in partnership' with families.

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This paper presents findings from a 2-year study of community nursing services for people affected by HIV infection in six health authorities in England. The research, commissioned by the Department of Health, England, aimed to identify the main bridges and barriers to effective home nursing care, focusing on discharge co-ordination, district nursing and multi-agency collaboration. Using a triangulated, case study approach, the main methods of data collection included non-participant observation, case note analysis, semi-structured staff interviews, a postal questionnaire of district nurses and a series of focus groups with service users. Study sites included three cities and surrounding districts in the north west, north and south east of England. Findings suggest there is considerable room for improvement in discharge planning and that good practice is not the preserve of specialist units. District nurses are shown to be willing providers of the majority of home nursing care to this client group, but there is a need for more focused training, greater use of care co-ordinators and more emotional and managerial support.