National Evaluation of the Professional Nurse Advocate Programme: SUSTAIN

Introduction: The Professional Nurse Advocate (PNA) programme is a clinical leadership intervention which comprises a Level 7 training module developed by NHS England (2021)1. The aim is to equip nurses with the skills to deliver restorative clinical supervision to their peers and improve wellbeing following the Pandemic. To date, 8000 nurses across England have completed the training. A national evaluation was completed in June 2023, reported here.

Methods: Underpinned throughout by Laschinger’s Empowerment Theory2, the evaluation involved:- a literature review; survey; case studies; interviews and co-design workshop. Five participant groups were sampled: Health Education Providers (HEI); Regional and Site PNA Leads; Nurses in PNA roles and Nurses who received Restorative Clinical Supervision (RCS). Programme interventions were translated through the Logic Model. Ethics approval number: P139411.

Results: 302 survey responses were received (RCS Nurses n=73, PNAs n=214, Trust PNA Leads n=15). Of the 214 PNA respondents, 175 (81.8%) had delivered RCS and 39 (18.2%) had not. 63 interviews were conducted with Regional PNA leads (6), Trust PNA leads (13), PNAs (32) and RCS Nurses (7). All surveyed groups provided a median rating of ‘strongly agree’ to the statement “I believe that restorative clinical supervision is effective”, illustrating strong support for the effectiveness of RCS. Interviews participants emphasised the importance of sharing expertise to evolve the programme. Case Studies indicated the momentum and organisation required for successful implementation. PNAs described the need for adequate time to undertake the role. RCS Nurses identified feeling restored, reinvigorated and more confident after RCS.

Discussion: The support of PNAs is helping nurses to feel valued and empowered. Nurses are also learning new ways to develop resilience at work. In some cases, RCS is enabling nurses, who might otherwise leave the profession, to stay. These factors are important in the context of a global workforce recruitment and retention crisis3.

NHS England & NHS Innovation (2021) PAR799: Professional Nurse Advocate A-EQUIP model: A model of clinical supervision for nurses. Available from: https://www.england.nhs.uk/wp-content/uploads/2021/12/B0799-national-professional-nurse-advocate-implementation-guide-with-links.pdf, Accessed 23/6/23.

Laschinger, H.K., Finegan, J. and Shamian J. (2001). Impact of Structural and Psychological Empowerment on Job Strain in Nursing Work Settings. Expanding Kanter’s Model. Journal of Nursing Administration, 1, 260-272. http://dx.doi.org/10.1097/00005110-200105000-00006

Muscat, H., Morgan, L., & Hammond, K. (2021). Staff burnout: how a nurse advocate course can help: Programme uses a model of restorative clinical supervision proven to boost well-being and patient outcomes. Learning Disability Practice, 13-14.