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Nursing Peer Review: A Means to Improvement

By HCPro's Advisor to the ANCC Magnet Recognition Program®  
   August 01, 2010

Peer review: the evaluation of the professional performance of individual RNs by nurses with experience in the appropriate subject matter to provide a legitimate evaluation. It sounds simple, but the concept of nursing peer review has its own set of unique challenges. Despite these challenges, it remains a powerful way to educate and bring about quality improvement. 

But who is a peer? A nurse peer is an RN who practices in the same role as the RN being reviewed. This means: 

  • Bedside to bedside
  • Nurse manager to nurse manager
  • Nurse educator to nurse educator
  • CNS to CNS

Only nurses who are in the same (or comparable) role can provide the kind of evaluation of patient care and nursing practice required for proper peer review.

“In the clinical or any healthcare setting, I always like to ask, ‘What motivates change?’ ” Meryl Montgomery,  RN, MSN, ANCC Magnet Recognition Program® (MRP) coordinator for the Medical Center of Central Georgia in Macon, told a live audience during the webcast “Nursing Peer Review: Improving Clinical Performance, Professionalism, and Accountability.” “How do we ensure quality of care? Improve conditions? What is the best way to address a near miss and be constructive?” 

Montgomery has found over the years that peer review has the power to drive system improvement. 

“It can be very creative and innovative in where you can go—you can engage your nurses across the board,” she said. 

Peer review is a situation where “apples to apples” is a necessity. OR nurses really need to be the ones evaluating OR nurses; likewise with OB nurses to OB nurses and critical care to critical care.

“The distinctions between those roles can be important and need to be looked at,” said Montgomery.

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