Inside scoop from our experts: Tackling peer review in the OR

HCPro's Weekly Update on the ANCC Magnet Recognition Program®*, December 15, 2009

This week, a reader asks about peer review and OR nurses. This question generated lots of responses on the JourneyTalk listserv, and the following answers are from a JourneyTalk member and advisor Meryl Montgomery, RN, MSN, ANCC Magnet Recognition Program® coordinator at the Medical Center of Central Georgia (MCCG) in Macon:

Q: In the OR, staff nurses do not work with other staff nurses in the same way as on other units, and they feel they do not have the same opportunity for true nurse-to-nurse peer review as other units do. How is peer review evaluation conducted in the OR?

A: JourneyTalk member: Peer review includes the following processes with which OR nurses can most definitely participate and contribute:

  • Staff nurses sit on interview panels to hire other OR staff nurses and managers
  • Perioperative staff nurses can be included in:
    • root cause analyses when there are occurrences
    • review of never events and near misses
    • PI activities where there are opportunities for improvement based on data, targets, and benchmarks
  • Perioperative nurses also perform peer review when they relieve each other-they have the opportunity to assess other RN's practice during report

Meryl Montgomery: We use informal peer review at MCCG and utilize both written and verbal peer review, which begins with pre-hire interview peer panels, and includes ongoing competency and quality assessment peer review, and annual performance evaluation peer review. HCPro has a webcast on January 11 that will highlight some more tools, as well as both formal and informal peer review.

Since our process isn't incident based, we roll peer review into infrastructure across the board: shared governance; performance improvement/quality assurance; evaluation; competency assessment; education, training, and knowledge validation; professional nurse ladder; skills days, etc. Our performance review process is online and automated, so feedback at this level is anonymous. Others, such as quality assurance, involve face-to-face review of findings. Since The Joint Commission also requires peer review, we have had an annual requirement for many years.

Editor's note: On JourneyTalk you can network with your peers, discuss the new manual, share your helpful tips, and get advice on how to meet the program's expectations. Become a member of JourneyTalk when you subscribe to HCPro's Resource Center for the ANCC Magnet Recognition Program®.

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