Assessing RN-to-RN peer review on clinical units

Quality of outpatient nursing care: a scoping review

to map national and international scientific literature on the quality of outpatient nursing care.

a scoping review guided by the Joanna Briggs Institute Collaboration, conducted across 12 databases and repositories. Only original articles evaluating the quality of outpatient nursing care were included. No restrictions were applied regarding time, methodology, or language. Data were mapped and organized through thematic and statistical descriptions of the articles. This review was registered on the Open Science Framework platform.

a total of 45 studies published between 1984 and 2021 were identified, resulting in 17 quality indicators for outpatient nursing care, grouped according to Donabedian's triad: four for structure, seven for process, and six for outcomes. The predominant area of care was oncology. Among the analyzed studies, 55.3% focused on patients. The most frequently cited indicators were continuing health education, service organization, communication, care coordination, and the nursing process.

the limited number of studies in this field, compared to other areas of nursing, highlights the underexploitation of the topic both nationally and internationally. Additionally, the diversity of identified indicators underscores the lack of standardization in these data.

BACKGROUND

(1) Few studies address the evaluation of outpatient nursing care quality.

BACKGROUND

(2) Quality indicators identify challenges in healthcare services.

BACKGROUND

(3) Publications on outpatient nursing care quality have increased since 2000.

BACKGROUND

(4) Most of the evaluated studies focused on outpatient patients.

BACKGROUND

(5) The most frequently cited quality indicator in the studies was Continuing Health Education.

Peer Review Processes for Quality Improvement in Health Care Settings and Their Implications for Health Care Professionals: A Meta-Ethnography

INTRODUCTION

Peer review processes are used to improve professional practice in health care, although no synthesis of existing studies has yet been undertaken. These processes are included in the UK professional revalidation processes for medical practitioners and nurses and midwives but not for allied health professionals. The purpose of this review was to identify, appraise, and synthesize the available qualitative evidence regarding health care professionals' experiences and views about peer review processes and to explore the implications for health care professionals in the United Kingdom.

METHODS

Qualitative review using meta-ethnography, reported according to Meta-ethnography Reporting Guidance guidance. Search strategy was developed using MeSH headings. The following data sources were searched: Cumulative Index to Nursing and Allied Health Literature, MEDLINE, and Ovid full text (between May 2007 and May 2019) (one reviewer with librarian support) plus manual searching. Screening, data extraction, and evaluation were undertaken independently by two reviewers. Studies were independently appraised for quality by two reviewers to identify concepts which were compared and developed into a conceptual model by the team.

RESULTS

Thirteen studies (937 participants) were included. Findings explored peer review processes and three key components, namely, purpose, process, and peers. Participants' perceptions of peer review processes were categorized by four main concepts: value/benefits, reflection/shared learning, anxiety about the process, and how to improve "buy-in."

DISCUSSION

Evidence supports the introduction and use of peer review processes as a quality improvement tool. Further research exploring whether/how to incorporate peer review processes into the process of assessing continuing fitness to practice for allied health professionals seems appropriate. The time and resources required to implement peer review processes are considered barriers to implementation.

The redesign of an advanced practice registered nurse professional evaluation process and tool at a midwest academic medical center: A pilot project

BACKGROUND

Inconsistency and a lack of clarity exist regarding the advanced practice registered nurse peer review process in hospitals throughout the country.

LOCAL PROBLEM

The current APRN peer review process in place for over a decade at an academic medical center has never been evaluated, and neither fulfills ongoing professional practice evaluation requirements nor meets the expectations of peer review.

METHODS

Pre-post intervention quality improvement project (Standards for Quality Improvement Reporting Excellence checklist).

INTERVENTIONS

Using current professional standards and guidelines that meet the requirements for ongoing professional practice evaluation and nursing peer review, a redesigned process and tool was created and piloted in three specialty groups of nurse practitioners (NPs) at the medical center. Satisfaction before and after the pilot survey was measured using a Likert-type scale, and results were compared and analyzed following the completion of the pilot survey.

RESULTS

The posttest measure revealed a statistically significant improvement in satisfaction with the redesigned professional evaluation tool compared with the prepilot peer review tool.

CONCLUSIONS

The redesign project demonstrated that using current professional standards and guidelines, a comprehensive process and tool for professional evaluation and peer review is achievable across NP specialties.

Integrating Peer Review into Nursing Practice

: Clinical nurses develop a program to strengthen professional relationships and practice.

Asking for Feedback: Clinical Nurses' Perceptions of a Peer Review Program in a Community Hospital

OBJECTIVE

The purpose of this study was to understand clinical nurses' perceptions of their participation in a formal, annual peer review process at a metropolitan community hospital.

BACKGROUND

Peer review is an essential component of professional nursing practice for self-regulation of the practice and promotion of quality and safety. Robust empirical evidence of formalized and effective peer review nursing processes is not evident.

METHODS

A descriptive qualitative study with focus group interviews was used.

RESULTS

Study results validate that peer review is a meaningful and valuable process used by clinical nurses to support professional growth and development. Nurses reported using their specific peer feedback as part of their annual goal setting.

CONCLUSIONS

Results validate the importance of implementation of a structured, formal peer review process at the organizational level. The study findings identify that the essential components of an effective peer review process include education for peer facilitators and clinical nurses; dedicated time, space, and privacy to conduct peer reviews; and leadership support.

Peer-Review Competency Assessment Engages Staff and Influences Patient Outcomes

BACKGROUND

Nurse educators must guide competency assessment in a way that influences safe patient care. The goal of this innovative competency assessment was for RNs to demonstrate performance of sound practice related to anticoagulation medication, pressure injuries, and pain management using a peer-review format.

METHOD

The process was initiated through the unit-based team. The clinical RN was required to bring forth the information that he or she had met the competency requirements. Rubrics provided consistency in evaluation.

RESULTS

The process was perceived to have evaluated actual performance and allowed demonstration of performance. For patient outcomes, anticoagulation safety measures were sustained, pressure injury measures were improved, and pain outcome measures were not improved during and after the competency period.

CONCLUSION

A peer-review process for clinical RN competency assessment enhanced professionalism through professional practice evaluation, was perceived as favorable, and was associated with positive patient outcomes. J Contin Educ Nurs. 2018;49(3):119-126.

Clinical Nurse Specialists Guide Staff Nurses to Promote Practice Accountability Through Peer Review

PURPOSE

The aim of the study was to describe the clinical nurse specialist role in developing and implementing a staff nurse education program to promote practice accountability using peer review principles.

BACKGROUND

Peer review is essential for professional nursing practice demanding a significant culture change. Clinical nurse specialists in a Magnet-designated community hospital were charged with developing a staff nurse peer review education program.

RATIONALE

Peer review is a recognized mechanism of professional self-regulation to ensure delivery of quality care. The American Nurses Association strongly urges incorporating peer review in professional nursing practice models. Clinical nurse specialists play a critical role in educating staff nurses about practice accountability.

DESCRIPTION

Clinical nurse specialists developed an education program guided by the American Nurses Association's principles of peer review. A baseline needs assessment identified potential barriers and learning needs. Content incorporated tools and strategies to build communication skills, collaboration, practice change, and peer accountability.

OUTCOME

The education program resulted in increased staff nurse knowledge about peer review and application of peer review principles in practice.

CONCLUSION

Clinical nurse specialists played a critical role in helping staff nurses understand peer review and its application to practice.

IMPLICATIONS

The clinical nurse specialist role will continue to be important in sustaining the application of peer review principles in practice.

The meaning of collaboration, from the perspective of Iranian nurses: a qualitative study

BACKGROUND

Interdisciplinary collaboration among nurses is a complex and multifaceted process, an essential element in nursing, which is crucial to maintain an efficient, safe, and viable medical setting. The aim of this study was to explore the meaning of concept of collaboration through conducting a qualitative research approach.

METHOD

The present study is qualitatively conducted in a content analysis approach. The data collection process included 18 unstructured and in-depth interviews with nurses during 2012-2013 in educational medical centers of west and northwest of Iran. A purposive sampling method was used. All the interviews were recorded, transcribed, and finally analyzed using a qualitative content analysis with a conventional method.

RESULT

Categories obtained from analysis of the data to explain the meaning of collaboration consist of (i) prerequisites of collaboration, (ii) actualization of collaboration, and (iii) achievement of a common goal.

CONCLUSION

The results of the present study ended in the discovery of meaning of collaboration that confirm results of other related studies, hence clarifying and disambiguating the concept under study. These results also contribute to the development of collaboration theories and the relevant measurement tools.