RN-to-RN Peer Review on Clinical Units

Pfeiffer, Judith A.

Friday, 3 August 2012: 10:35 AM

Judith A. Pfeiffer, PhD, RN
Department of Nursing Education, Development, & Research, UC San Diego Health System, San Diego, CA
Mary A. Wickline, MLIS, MEd
Biomedical Library, UC SAN DIEGO, La Jolla, CA
Jill Deetz, BSN
UC San Diego Health System, San Diego, CA
Elise L. Berry, MA
Nursing Quality, UC San Diego Health System, San Diego, CA

Learning Objective 1: The learner will be able to distinguish peer review as separate from annual performance review.

Learning Objective 2: The learner will be able to identify barriers to peer review and potential methods towards improving communication among staff nurses.

Purpose: The purpose of this study was to measure informal RN-to-RN peer review defined as collegial communication about the quality of nursing care at the work-unit level. In multiple studies, the top-ranked factor related to quality of nursing care is working with other nurses who are clinically competent. Nurses experience psychological or moral distress when they do not feel competent or when colleagues’ nursing practice is perceived as suboptimal.

Methods: We used a survey design with cluster sampling of 28 hospital and ambulatory care units (n = 541 respondents). We modified Hughes’s Peer Group Caring Interaction Scale and collected qualitative data through open-ended questions and comment boxes. A chi-squared test was used to compare responses against nurse characteristics.

Results: Results were compared with existing patient safety and satisfaction data. There were no correlation with patient safety or patient satisfaction. Misunderstandings about the meaning of peer review were evident. Open-ended comments revealed barriers to peer review: fear of retribution, language barriers and lack of professionalism.

Conclusion: Nurses need clarification of peer review. Issues with common language in a professional environment need to be addressed. Nurses can learn collaboration from each other's cultures.

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