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Improving Nursing Quality Through On-Site Supervision: A Process Management Intervention Guided by the
Min Li1, Yueqin Li1, Maoqing Fan1
1Department of Nursing, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, Taiyuan, 030032, China.
Aim(S):
To develop and evaluate an Structure-Process-Outcome (SPO) model-based on-site supervision program for nursing process management, and to assess its impact on nursing compliance, competency, patient satisfaction, and adverse events.
Background:
The SPO model provides a comprehensive framework for evaluating healthcare quality, yet its translation into practical on-site nursing supervision tools remains limited. Nursing quality assessments frequently emphasize retrospective outcome indicators while offering limited insight into real-time procedural adherence.
Method(S):
A pre-post quasi-experiment was conducted in a tertiary hospital (January 2024-December 2025), comparing outcomes between independent annual cohorts of nurses (2024 vs. 2025) within the same wards. Participants were not individually matched across the two phases. The intervention included a "1 + 1 + X" supervision team (Structure), formative evaluation with a "Ten Knowledges" checklist (Process), and a closed-loop feedback mechanism. Data were collected from nurses (n = 194) and patients (n = 155) and analyzed using t-tests and chi-square tests.
Results:
Nursing compliance (aseptic technique: 91.86% vs. 83.80%), skill scores (93.65 ± 2.28 vs. 91.80 ± 3.76), and patient satisfaction (97.44 ± 3.93 vs. 95.86 ± 5.26) improved significantly (p < 0.05). The annual number of documented nursing-related adverse events decreased from 559 in 2024 to 398 in 2025 (presented as raw counts without adjustment for total procedures).
Conclusion(S):
The SPO-based program was associated with improvements in nursing quality and patient safety indicators, suggesting a replicable strategy for nurse managers.
Implications For Nursing Management:
This program offers nurse managers a structured, theory-driven framework for on-site supervision that can be adapted across similar clinical settings. By strengthening procedural compliance, clinical competency, and patient-centered care, the approach provides a practical strategy for improving nursing quality and patient safety within existing resource constraints.
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