Clinical Supervision in Nursing and Evidence-Based Practices in Radial Haemostasis: A Pilot Study

To explore radial artery haemostasis practices in relation to recommended protocols, alongside the strategies and characteristics of clinical supervision among nurses providing this care.

The radial artery is the preferred access route for coronary angiography, but successful outcomes depend on appropriate postprocedure haemostasis management, primarily a nursing responsibility. Clinical supervision supports professional development and care quality, yet little is known about its relationship to haemostasis protocols in interventional cardiology settings.

A descriptive, cross-sectional study used an online questionnaire distributed among nurses from five Portuguese hospital centres performing coronary angiography via the radial artery, covering demographic data, haemostasis practices and clinical supervision strategies, analysed descriptively.

Among 96 nurses (65.6% female, mean age: 43.2 years, mean experience: 20.7 years), the TR Band device was the predominant haemostasis method, but full adherence to its manufacturer protocol was low (only 6.3% full compliance; 44.2% partial compliance). Partial compliance was similar regardless of cardiology experience, above or below 5 years (42.7% vs 50%). Substantial variability existed in postprocedure care, such as driving restrictions (24 h: 44.8%; 48 h: 47.9%) and puncture site management, with limited written materials provided (24.0%). Regarding clinical supervision, 88.5% lacked formal training. Supervisors favoured explanation and demonstration (87.3%) over feedback (45.1%) and discussion (43.1%). Time constraints and frequent job turnover were the main supervision barriers.

Considerable variation in adherence to the TR Band manufacturer's protocol was low and variable, underscoring the need for standardised nursing practice. Clinical supervision was predominantly didactic, with limited formative approaches and little formal supervisory training.

Nurse managers should consider reinforcing standardised haemostasis protocols through training and monitoring, and separately strengthening supervisor preparation and formative supervision approaches. Addressing time constraints and staff turnover may support both areas, though this cross-sectional study cannot establish that improved supervision enhances haemostasis practice.