Nurse-Family Partnership Supervisor Roles and Responsibilities for Implementation of an Intimate Partner Violence Intervention: An Interpretive Description Study

Abstract

The Nurse-Family Partnership® (NFP) is a home visitation program for young pregnant and first-time mothers affected by social and economic disadvantage. In response to intimate partner violence (IPV) experienced by women and children involved in the program, a nursing intervention was developed to support nurse home visitors identify and respond to IPV. Within each participating NFP team, supervisors were accountable for facilitating the implementation process of the IPV intervention for uptake into nurse home visitor practice. To understand the functions of NFP supervisors involved with the facilitation of the implementation process for the IPV intervention, an interpretive description approach was utilized involving primary data collection from interviews with 11 supervisors and 2 managers, and triangulated with secondary data from 7 focus groups (n=35 nurses). From this analysis, an NFP supervision framework was developed that included 4 domains, 7 roles, 3 sub-roles and multiple responsibilities. Supervision was found to involve roles and sub-roles functioning in oversight of implementation and others that functioned in the direct implementation of the IPV intervention, forming levels of supervision, and creating a hierarchy. A comprehensive appreciation of NFP supervisor domains, roles, sub-roles and responsibilities enacted during the implementation process is important to help identify the best alignment of human resources, recognize how the NFP can best support supervisors, and to champion achievement of current and future innovation implementation goals. Recommendations of support for supervisors include facilitating educational opportunities, creating transparency of the implementation process, developing a quality improvement strategy, providing supervisor mentorship, improving standardization, and recognizing the competing NFP priorities for supervisors and nurse home visitors.