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The Henderson Repository is a free resource of the Honor Society of Nursing, Sigma Theta Tau International. It is dedicated to the dissemination of nursing research, research- related, and evidence-based nursing materials. Take credit for all your work, not just books and journal articles. To learn more, visit www.nursingrepository.org Item type Presentation Format Text-based Document Title RN-to-RN Peer Review on Clinical Units Authors Pfeiffer, Judith A.; Deetz, Jill; Berry, Elise L.; Wickline, Mary A. Downloaded 20-May-2018 10:17:42 Link to item http://hdl.handle.net/10755/243247

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Page 1: RN-to-RN Peer Review on Clinical Units - Virginia · PDF fileRN-to-RN Peer Review on Clinical Units Judith Pfeiffer, PhD, RN, ... early planning and coding themes work ... • More

The Henderson Repository is a free resource of the HonorSociety of Nursing, Sigma Theta Tau International. It isdedicated to the dissemination of nursing research, research-related, and evidence-based nursing materials. Take credit for allyour work, not just books and journal articles. To learn more,visit www.nursingrepository.org

Item type Presentation

Format Text-based Document

Title RN-to-RN Peer Review on Clinical Units

Authors Pfeiffer, Judith A.; Deetz, Jill; Berry, Elise L.; Wickline,Mary A.

Downloaded 20-May-2018 10:17:42

Link to item http://hdl.handle.net/10755/243247

Page 2: RN-to-RN Peer Review on Clinical Units - Virginia · PDF fileRN-to-RN Peer Review on Clinical Units Judith Pfeiffer, PhD, RN, ... early planning and coding themes work ... • More

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

Page 3: RN-to-RN Peer Review on Clinical Units - Virginia · PDF fileRN-to-RN Peer Review on Clinical Units Judith Pfeiffer, PhD, RN, ... early planning and coding themes work ... • More

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

Page 4: RN-to-RN Peer Review on Clinical Units - Virginia · PDF fileRN-to-RN Peer Review on Clinical Units Judith Pfeiffer, PhD, RN, ... early planning and coding themes work ... • More

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.

Page 5: RN-to-RN Peer Review on Clinical Units - Virginia · PDF fileRN-to-RN Peer Review on Clinical Units Judith Pfeiffer, PhD, RN, ... early planning and coding themes work ... • More
Page 6: RN-to-RN Peer Review on Clinical Units - Virginia · PDF fileRN-to-RN Peer Review on Clinical Units Judith Pfeiffer, PhD, RN, ... early planning and coding themes work ... • More

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

Page 7: RN-to-RN Peer Review on Clinical Units - Virginia · PDF fileRN-to-RN Peer Review on Clinical Units Judith Pfeiffer, PhD, RN, ... early planning and coding themes work ... • More

Results

• Nurses affirmed that they practice peer review on their unit

But across almost all units, nurses felt they gave more than they

received

Page 8: RN-to-RN Peer Review on Clinical Units - Virginia · PDF fileRN-to-RN Peer Review on Clinical Units Judith Pfeiffer, PhD, RN, ... early planning and coding themes work ... • More

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

Page 9: RN-to-RN Peer Review on Clinical Units - Virginia · PDF fileRN-to-RN Peer Review on Clinical Units Judith Pfeiffer, PhD, RN, ... early planning and coding themes work ... • More

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.

Page 10: RN-to-RN Peer Review on Clinical Units - Virginia · PDF fileRN-to-RN Peer Review on Clinical Units Judith Pfeiffer, PhD, RN, ... early planning and coding themes work ... • More

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

Page 11: RN-to-RN Peer Review on Clinical Units - Virginia · PDF fileRN-to-RN Peer Review on Clinical Units Judith Pfeiffer, PhD, RN, ... early planning and coding themes work ... • More

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

Page 12: RN-to-RN Peer Review on Clinical Units - Virginia · PDF fileRN-to-RN Peer Review on Clinical Units Judith Pfeiffer, PhD, RN, ... early planning and coding themes work ... • More

Defining the Elements of Peer Review

• Peer means at the same level

(no hierarchical relationship)

Page 13: RN-to-RN Peer Review on Clinical Units - Virginia · PDF fileRN-to-RN Peer Review on Clinical Units Judith Pfeiffer, PhD, RN, ... early planning and coding themes work ... • More

• Peer means at the same level

(no hierarchical relationship)

• Focus is on the work

Elements of Peer Review

Page 14: RN-to-RN Peer Review on Clinical Units - Virginia · PDF fileRN-to-RN Peer Review on Clinical Units Judith Pfeiffer, PhD, RN, ... early planning and coding themes work ... • More

• Peer means at the same level

(no hierarchical relationship)

• Focus is on the work

• Not confrontational – it’s collegial

Elements of Peer Review

Page 15: RN-to-RN Peer Review on Clinical Units - Virginia · PDF fileRN-to-RN Peer Review on Clinical Units Judith Pfeiffer, PhD, RN, ... early planning and coding themes work ... • More

• Peer means at the same level

(no hierarchical relationship)

• Focus is on the work

• Not confrontational

• Not anonymous

Elements of Peer Review

Page 16: RN-to-RN Peer Review on Clinical Units - Virginia · PDF fileRN-to-RN Peer Review on Clinical Units Judith Pfeiffer, PhD, RN, ... early planning and coding themes work ... • More

• Peer means at the same level

(no hierarchical relationship)

• Focus is on the work

• Not confrontational

• Not anonymous

• Tone is professional

Elements of Peer Review

Page 17: RN-to-RN Peer Review on Clinical Units - Virginia · PDF fileRN-to-RN Peer Review on Clinical Units Judith Pfeiffer, PhD, RN, ... early planning and coding themes work ... • More

• 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

Elements of Peer Review

Page 18: RN-to-RN Peer Review on Clinical Units - Virginia · PDF fileRN-to-RN Peer Review on Clinical Units Judith Pfeiffer, PhD, RN, ... early planning and coding themes work ... • More

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), 390-400.

DOI:10.1111/j.1365-2834.2011.01321.x

• Hughes L. (1998) Development of an instrument to

measure caring peer group interactions. Journal of Nursing

Education, 37(5), 202–207.

• Haag-Heitman B. & George V. (2011). Peer review in

nursing: Principles for successful practice. Sudbury, MA:

Jones & Bartlett.