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Peer Audit and Feedback: A Documentation-Focused Quality Improvement Project
Michal I Glass1, Kelly Powers, Laura M Magennis
1Author Affiliations: Department of Medical Staff Quality, Corporate Quality, Atrium Health Waxhaw, North Carolina (Dr Glass); School of Nursing, College of Health and Human Services, UNC Charlotte Charlotte, North Carolina (Dr Powers); School of Nursing, College of Health & Human Services, UNC Charlotte Charlotte, North Carolina (Dr Magennis), and Nursing Excellence, Enterprise Nursing, Atrium Health Nursing Administration (Dr Shaw).
Background And Objectives:
Nurses' documentation of communication, including notification of critical laboratory results (CLR), is important to ensure safe, high-quality care. Evidence supports peer audit with feedback as a quality improvement (QI) intervention to improve documentation. Nursing compliance with CLR documentation requirements was below goal for several years in an intensive care unit. To address this problem, a peer audit and feedback intervention was implemented and evaluated.
Methods:
Compliance with CLR documentation requirements was evaluated pre- and postintervention, for a total of 12 months. The evaluation also included data from the peer audits and a survey to assess nurses' perceptions. The 5-month intervention was a timely peer audit and feedback of CLR events.
Results:
CLR documentation compliance improved from 6.4% to 9.6% (50% improvement), which was clinically meaningful but not statistically significant. Nurses had overall positive perceptions of the peer audit and feedback as a QI tool, perceiving it as nonpunitive and helpful for improving practice.
Conclusion:
Results support continued examination of peer audit and feedback to improve nursing documentation. Future projects should address the limited time for nurses to engage in QI projects.
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