A conceptual analysis of reflective supervision for creating a positive intensive care practice environment.

Objectives: This study aimed to explore and clarify the concept of reflective supervision as a professional self-care strategy to create a positive Intensive Care Unit (ICU) practice environment. Methods: Walker and Avant's eight-step concept analysis approach was utilized to identify and define the attributes, antecedents, and consequences of reflective supervision in the ICU. An extensive literature search was conducted across various databases, including Google Scholar, CINAHL, PubMed. Articles published from 2005 to 2025 were identified. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement to indicate the included articles and extract related data based on relevance. Results: Forty articles were included in the analysis. The identified attributes included the supervisor-supervisee relationship, effective communication, teamwork, collaborations, reflection, competencies, feedback, continuous support, and autonomous choice. The identified antecedents included participation, supportive supervision, flexibility, open-door policy, training, and motivation. Consequences impacting the success of reflective supervision were identified as promotion of resiliency, autonomy, work-life balance, self-awareness, increased self-esteem, professional development, critical thinking, increased job satisfaction, and enhanced commitment. Conclusions: Reflective supervision is a complex professional self-care strategy that enhances ICU practice, by promoting nurses' well-being, self-awareness, therapeutic skills, and professional development.