Peer Response
ANSWERS
A peer is someone who performs similar roles and has the same rank, education, clinical expertise, and level of licensure as you. “As the professional association for nursing, ANA has a responsibility to the public and its members to facilitate the development of a quality assurance system, including peer review,” according to the ANA Peer Review Guidelines position statement. Given this, each nurse must participate in the decision-making process for evaluating nursing care, which is known as peer review. The peer review process encourages professionalism by increasing accountability and promoting the nursing profession’s self-regulation.
The definition of peer review is “an organized effort in which practicing professionals review the quality and appropriateness of services ordered or performed by their professional peers.” It is defined as the “process by which practicing registered nurses systematically assess, monitor, and make judgments about the quality of nursing care provided by peers as measured against professional standards of practice” in nursing. The goal of peer review is to improve practice. It is the mechanism that is used to:
Based on practice standards, assess the quality and quantity of nursing care.
Based on practice standards, assess the strengths and weaknesses of nursing care.
Provide evidence to support changes in practice protocols to improve care.
Recognize practice patterns that indicate a need for additional knowledge.
Peer review is neither punitive nor anonymous. In addition to considering the nurse’s rank and nursing practice, it is intended to consider the nurse’s developmental stage, to foster a continuous learning culture of patient safety and best practice, and to provide continuous, timely, and routine feedback.
Peer evaluation is a performance evaluation component commonly linked to professional goals, compensation, and consequences. A peer always completes peer evaluation; however, if it is done as part of a 360-degree process, it should be completed by all contributing team members (some of whom may or may not be peers). Peer evaluation is optional, but peer review is not. The organization has the option of conducting 360-degree evaluations; however, peer review is NOT optional for a professional.
For nurses at all levels (staff nurses up to the CNO), the Organizational Overview (OO-10) requires evidence of the following documents:
Tools for self-evaluation
Tools for peer feedback
Performance evaluation tools
The self-appraisal tool, also known as the self-evaluation tool, is used by the individual to assess their performance against specific standards, goals, and objectives. Peers use the peer feedback tool to assess their peers’ performance against specific organizational standards, goals, and objectives. It is intended to provide feedback based on observed performance, allowing the receiver to understand personal and professional strengths and gaps in practice or performance. Peer feedback allows a staff member to learn more about their performance or validate a personal perspective or point of view. 6 It should allow the receiver to leave knowing exactly what they did and the impact.
QUESTION
Peer Response
PICOT: For adults aged 40 and older with heart failure in a primary care clinic, does the implementation of the Agency for Healthcare Research and Quality (AHRQ) Re-Engineered Discharge (RED) Toolkit via telemedicine, compared to current practice, impact 30-day readmission rates over 14 weeks?
Heart failure has been a predominant cause of death for nearly a century (Khan et al., 2020; Schrage et al., 2020). Readmissions related to the worsening disease process have significant repercussions for healthcare, including decreased reimbursement. An integrative review was completed to answer if utilizing the RED Toolkit coupled with telemedicine reduced heart failure readmissions. Results indicated decreased readmissions by upwards of 30%, improved morbidity and mortality rates, and quality of life (Hunt‐O’Connor et al., 2021; Jenneve et al., 2020; McKay et al., 2019; Mitchell et al., 2017; Patel & Dickerson, 2017; Roberts et al., 2018; Sullivan et al., 2018).