Nurse managers' conceptions of quality management as promoted by peer supervision.
OBJECTIVE
The aim of the study was to describe nurse managers' conceptions of quality management in their work as promoted by peer supervision.


BACKGROUND
Quality management is one of the topical issues in a nurse manager's demanding and changing work. As first-line managers, they have a key role in quality management which is seen to create the system and environment for high quality services and quality improvement. Despite the official recommendations and definitions of quality management, several published reports have shown that there is no single solution for quality management. Peer supervision or the support provided by it to nursing managers have rarely been a subject of study. This study was carried out at Tampere University Hospital between 1996 and 1998. The peer supervision intervention was organized once a month, 2 hours at a time and in closed supervisor-led groups of nine nurse managers.


METHODS
Data were collected by themed interviews. Fifteen nurse managers participated in the study. The data were analysed using the phenomenographic method.


RESULTS
Two main categories were formed of nurse managers' conceptions. The first described supportive and reflective characteristics of peer supervision. This main category was described by horizontal, hierarchical categories of support from peer group and reflection. The second main category described nurse managers' conceptions of individual development of leadership during peer supervision. This main category was also described by three horizontal categories: personal growth, finding psychological resources and internalization of leadership.


CONCLUSIONS
The finding of this study show that peer supervision benefited nurse managers in quality management through reflection and support. The reflective and supportive characteristics of peer supervision promoted the nurse managers' individual development, but also that of leadership. It can be concluded that peer supervision promotes quality management in nurse managers' work.
Hyrkäs
Kristiina
K
Department of Nursing Science, University of Tampere, Finland. nueihy@uta.fi
Koivula
Meeri
M
Lehti
Kristiina
K
Paunonen-Ilmonen
Marita
M
D001291:Attitude of Health Personnel; D005260:Female; D005387:Finland; D006801:Humans; D007857:Leadership; D008297:Male; D009741:Nursing Staff, Hospital / Q000523:psychology*; D009745:Nursing, Supervisory / Q000592:standards*; D018024:Peer Review, Health Care; D012944:Social Support; D017749:Total Quality Management