Peer 2 Peer Feedback: A Novel Approach to Quality Outcomes, Collaboration and Peer Review

Purpose:
The project aim was to design, implement and evaluate an innovative and contemporary model of peer feedback with clinical nurses in the acute care setting supported by information technology (IT).

Relevance/Significance:
The American Nurses Credentialing Center's (ANCC) Magnet RecognitionŽ and Pathway to ExcellenceŽ programs recognize the importance of nursing peer review, peer feedback and quality outcomes. Both ANCC programs require documentation and demonstration of peer review and feedback tools.

Strategy and Implementation:
The project aim was to design, implement and evaluate an innovative and contemporary model of peer feedback with clinical nurses in the acute care setting supported by information technology (IT). Peer feedback is a process where clinical nursing staff were expected to provide constructive feedback to other clinical nurses based upon a comparison of observed nursing care to nursing practice standards, policy and/or expectation of patient care in the practice setting. The project was evaluated by assessing the effect of peer feedback on patient outcomes with an initial focus on patient falls and hospital-acquired pressure ulcers. The implementation of peer feedback occurred over a period of six quarters beginning 4th quarter 2013 and ended in 1st quarter 2015.

Evaluation:
Fall data indicated a 7.6% overall reduction in patient falls in (3) service lines and pressure ulcer data indicated an a 50% overall reduction in hospital-acquired pressure ulcers in (3) service lines of medical-surgical, pediatric and critial care service lines.

Implications for Practice:
The most significant lessons learned during the first year was the need and the importance of teaching nurses how to give and receive constructive feedback, the importance of unit-based council involvement and inclusion of unit-specific observation measures.