Assessing RN-to-RN Peer Review on Clinical Units

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1 Assessing RN-to-RN Peer Review on Clinical Units Judith Pfeiffer, PhD, RN, NEA-BC Mary A. Wickline, MLIS, M.Ed. Jill Deetz, RN, BSN, NE-BC Elise Berry, MA

2 Acknowledgements Instrument adapted with permission from Linda Hughes (1998) Peer Group Caring Interaction Scale Fellow researchers Mary Hackim - early planning and coding themes work Daniel Patiag & Edita Petil - assisted with data collection by walking the floors to encourage participation

3 Peer Review is NOT the same as annual evaluation Peer Review is collegial communication about the quality of nursing care among nurses who work together.

4

5 Assessing RN-to-RN Peer Review on Clinical Units Nurse Characteristics & Research Methods Sample n=541 (38% response rate) Mean Age = 43 65% Bachelor s degree in nursing 54% Caucasian / 27% Filipino Years of experience: 34% >20 yrs as nurse, 20% <6 yrs as nurse Mean yrs. on current unit: 8 years Methods cross-sectional survey Modified Hughes Peer Group Caring Interaction Scale Changed from: students at this school To: nurses on my unit 3 additional open-ended questions Also, comment boxes on each page of questions

6 Results Nurses affirmed that they practice peer review on their unit But across almost all units, nurses felt they gave more than they received

7 Results Nurses affirmed that they practice peer review on their unit But across all units, nurses felt they gave more than they received and felt like they valued peer review received more than their peers did. RNs with BSN were more likely (than Master s, Associate, or Diploma prepared nurses) to agree with statement: RNs on my unit think it should be left up to the nurse manager(s) to work with RNs who need extra help related to patient care

8 Results Nurses affirmed that they practice peer review on their unit But across all units, nurses felt they gave more than they received and felt like they valued peer review received more than their peers did. RNs with BSN were more likely (than Master s, Associate, or Diploma prepared nurses) to agree with statement: RNs on my unit think it should be left up to the nurse manager(s) to work with RNs who need extra help related to patient care. More Filipino nurses than Caucasian or Latino agreed: RNs on my unit help each other by sharing information sources, research articles or evidence related to our patient care.

9 Barriers to Peer Review -- from open-ended questions & comments 1. Lack of clarity about what constitutes peer review 2. Fear of peer retribution 3. Language and cultural differences 4. Lack of respect and professionalism

10 What can we do to improve peer review? Clear definition, broadly disseminated and actively supported throughout the organizational climate. Professional communication Teach what it looks like Expect it as part of normal skill set Assess and train further where needed

11 Defining the Elements of Peer Review Peer means at the same level (no hierarchical relationship)

12 Elements of Peer Review Peer means at the same level (no hierarchical relationship) Focus is on the work

13 Elements of Peer Review Peer means at the same level (no hierarchical relationship) Focus is on the work Not confrontational it s collegial

14 Elements of Peer Review Peer means at the same level (no hierarchical relationship) Focus is on the work Not confrontational Not anonymous

15 Elements of Peer Review Peer means at the same level (no hierarchical relationship) Focus is on the work Not confrontational Not anonymous Tone is professional

16 Elements of Peer Review Peer means at the same level (no hierarchical relationship) Focus is on the work Not confrontational Not anonymous Tone is professional Purpose = assist each other to assure excellent patient care

17 References Pfeiffer JA, Wickline MA, Deetz J, Berry EL. (2012). Assessing RN-to-RN peer review on clinical units. Journal of Nursing Management, 20(3), DOI: /j x Hughes L. (1998) Development of an instrument to measure caring peer group interactions. Journal of Nursing Education, 37(5), Haag-Heitman B. & George V. (2011). Peer review in nursing: Principles for successful practice. Sudbury, MA: Jones & Bartlett.

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