Although the concept of nursing peer review is over two decades old, it is just coming of age in the correctional nursing specialty as the newest version of the National Commission on Correctional Health Care Accreditation Standards has expanded the Clinical Performance Enhancement Program (Standard C-02) to include RNs and LPNs. This is the fourth in a 4-part series of posts on correctional nursing peer review. Find other posts on this topic here.
Recently I queried correctional nurse leaders around the country about what they were doing regarding nursing peer review. Many responded that they were researching the process and just getting started. Here are examples of what some systems have developed thus far. They may help you determine what would be best for your purposes.
The Washington state prison system is using a form to document peer review of these practice factors:
- MAR Completion
- Completion of Assessments
- Nurse Care Plan & documented follow-up
- Seeks Consultation Appropriately
- Appropriate Application of Guidelines
- Clinical Knowledge Base
- Interest in Improving Skills
- Patient-oriented Care
- Professional Ethics
- Patient Education
- Observed Clinical Skills
- Critical thinking skills
- Delegates tasks appropriately
Armor Correctional Health Services, Inc. is using a system that follows the nursing process, reviewing documentation for these practice factors:
- Legibility of notes
- Each entry includes date, time, signature and printed name
- Sufficient information to understand the condition
- Appropriate assessment includes objective information about the condition
- Appropriate format and documentation (ie: soap v. incidental note, abbreviations)
- Ordering of medication (from the right vendor, right medication, right dose)
- Documentation on the medication administration record
- Completion of referrals as appropriate
The Ohio state prison system has had a nursing peer review program in place since 2007. They review nursing documentation for each nurse every 2 years. Ten charts are selected – 5 by the reviewer and 5 by the nurse being reviewed. Their policy specifically states that results of the nursing peer review are never used as grounds for disciplinary or punitive action. Instead, a remediation plan may be initiated, if appropriate.
Are you developing a Nursing Peer Review program in your setting? Share your experiences in the comments section of this post.
To read more about professional practice issues see Chapter 19 in the Essentials of Correctional Nursing. The text can be ordered directly from the publisher and if you use Promo Code AF1402 the price is discounted by $15 off and shipping is free.
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