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Keywords:

  • peer review;
  • electronic fetal heart rate monitoring;
  • late deceleration;
  • perinatal safety;
  • patient safety;
  • quality improvement;
  • Plan-Do-Study-Act;
  • Virginia Henderson Need Theory

ABSTRACT

We describe a nurse peer-review process to improve late deceleration recognition and intervention on one labor and delivery unit. Monthly chart audits (n = 721) met the goal of 75% reviewer agreement after the 4th month of implementation and have been maintained to date. Nurses recognized for excellence were more likely to be certified, work day shift, or be a member of the Perinatal Safety Team. Institutional support, a dedicated review team, and education contributed to success.