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Updated: Feb 5, 2026

Using Learning Outcome Measures to assess Doctoral Nursing Education
Published on: June 21, 2010
Impact of Nurse Peer Review on a Culture of Safety
Cynthia R Herrington1, Mikel W Hand
1Administration, Indiana University Health Bloomington Hospital (Dr Herrington); and Department of Graduate Nursing, College of Nursing and Health Professions, University of Southern Indiana, Evansville (Dr Hand).
Background:
Nursing peer review (NPR) is essential in evaluating nursing practice. A common theme throughout the literature is that NPR holds nurses accountable for their practice.
Problem:
The nursing profession has struggled to conduct peer review consistently due to lack of a standardized framework.
Approach:
A NPR program was developed, implemented, and evaluated in a 355-bed acute care hospital in the Midwestern United States.
Outcomes:
A pre- and postdesign using the Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture was used for evaluation. Paired t test results revealed statistically significant differences in group means for 2 questions: mistakes have led to positive changes here (P < .001, d = 1.31), and staff will freely speak up (P = .002, d = 0.67). Clinically significant differences in group means were noted for the remaining survey items.
Conclusions:
Implementation of an NPR program is a promising means to improve the culture of safety in health care institutions.
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