Nursing peer review in a rural hospital labor and delivery unit: Implementation of a holistic peer-to-peer feedback process
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2025
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Problem Statement: The SCORE (Safety, Culture, Operational risk, Resilience/burnout and Engagement) survey is launched by a four-hospital healthcare system to routinely measure coworker perspectives on leadership, burnout, safety climate, teamwork, and improvement readiness. Individual department data from the survey demonstrated that nurses in the Family Birthing Unit are hesitant to speak up, discuss errors, and learn from others. In another staff survey, nurses from this unit scored low on trust amongst teammates. There is no formal process for peer-to-peer feedback in this unit. Purpose: The purpose of this project was to develop, implement, and evaluate a comprehensive nursing peer review process to increase nurse perception of teamwork, communication and overall culture of safety.
Methods: Nurses in the unit were educated about nursing peer review and randomly assigned to pairs. Using a peer review form, the nurses evaluated the nursing practice of their peer in a face-to-face conversation, sharing examples both of how their peer excels and areas of opportunities. Pre and post peer review surveys were done to measure peer interactions.
Results: After one round of peer review, nurse perception of how they are treated by their peers, having trusting relationships, and their working environment was rated more positively.
Discussion: Some nurses did report the random pairing process didn’t match them with someone they worked with often, making the process more difficult. However, by practicing peer to peer feedback using a structured approach, overall teamwork and safety climate can be improved. Peer review should be a routine practice, integrated into the culture for optimal outcomes.
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Nursing, comprehensive peer review, holistic peer review, peer evaluation, peer feedback
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72 pages
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