Nurse Opinion Helps Shape Peer Review

The direct care nurse aims to provide the highest standard of patient care, using evidence-based practice delivered in the safest manner. To achieve the highest standards nurses must routinely evaluate their own performance and participate in substantive peer review¹. Peer review is an organized effort and principled approach in which the quality and safety of nursing care is assessed in comparison to established standards, and non-biased feedback is provided ^3,4. Nurses are responsible for developing criteria for evaluation of practice and for using those criteria in both peer and self-assessments. Nurses also have a responsibility to plan establish, implement, and evaluate review mechanisms, including peer review, in order to safeguard patients and nurses¹. Additionally, peer review is an expectation of the American Nurses Credentialing Center Magnet Recognition Program². As a mechanism, peer review relies heavily on nurse participation; therefore, nurse perceptions are a key measurement to map progress toward shaping an effective and sustainable peer review program.

Nurses at an ANCC certified community hospital developed criteria for evaluation of practice using the mechaism of peer review. From 2012 through 2015 a Peer Review Committee has implemented skill assessments through peer review and provided education on methods to provide peer-to-peer feedback in a real-time framework. Moving forward, the Committee desired input from nurses about their perception of peer review in order to shape next steps. Data was obtained from nurses currently employed at the hospital through two surveys. The first survey related to a cohort of nurses trained in peer review that observed their peers perform a skill set. Nurses responded positively to peer review as an effective method to educate, promote skill, and increase accountability for performance. However, only 44% agreed that peer review was overall effective for adoption of a new skill. The second survey was targeted at the less formal everyday use of peer review and peer feedback. Hospital-wide, nurses were asked if peer review is actively used amongst nurses on their work unit; more than half of nurses surveyed agreed. This measurement of nurse opinions tell us there is an opportunity to craft a comprehensive peer review program that is effective and sustainable, in which nurses are primed to participate.