Collaborative Rural Nurse Peer Review: A Quality Improvement Project

Area of Science:

• Nursing Practice
• Healthcare Management
• Quality Improvement

Background:

• Peer review is fundamental to professional nursing.
• Implementing peer review presents challenges, particularly in small and rural hospitals.
• Limited nurse reviewers and potential bias are key barriers in these settings.

Purpose of the Study:

• To address challenges in implementing nursing practice peer review in small, rural hospitals.
• To develop recommendations for effective peer review processes in resource-limited settings.
• To create a sustainable model for rural nursing peer review.

Main Methods:

• A collaborative council with representation from rural and critical access hospitals was formed.
• Nursing leaders and staff nurses collaborated to identify barriers and propose solutions.
• Processes for case referral, review, investigation, and scoring were developed based on Just Culture principles.

Main Results:

• A collaborative rural nursing practice peer review council was established with multi-facility representation.
• Effective processes for case referral, reviewer assignment, investigation, and scoring were created.
• High satisfaction was reported among staff nurses, reviewers, and Chief Nursing Officers.

Conclusions:

• Collaborative approaches can mitigate barriers to nursing peer review in rural hospitals.
• This model demonstrates efficient and effective peer review processes for small, rural facilities.
• The collaborative council provides a successful framework for quality improvement in geographically distinct hospitals.