An innovative approach to peer review for the advanced practice nurse—A focus on critical incidents

Authors

  • Katherine J Kenny RN, MS, ANP, APRN, BC, CCRN,

    (Chair, Advanced Practice Nursing2, Adult Nurse Practitioner2, and Faculty Associate3), Corresponding author
    1. St. Joseph’s Hospital and Medical Center, Phoenix, Arizona
    2. Department of Internal Medicine, St. Joseph’s Hospital and Medical Center, Phoenix, Arizona
    3. College of Nursing and Healthcare Innovation, Arizona State University, Phoenix, Arizona
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  • Laurie Baker RN, MS, ANP, BC,

    (Adult Nurse Practitioner)
    1. Barrow Neurosurgical Associates, Phoenix, Arizona
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  • Marie Lanzon RN, MS, CPNP,

    (Pediatric Nurse Practitioner)
    1. Children’s Rehabilitation Services, St. Joseph’s Hospital and Medical Center, Phoenix, Arizona
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  • Lily R Stevens RN, ADN, BSN, MSN, FNP-C, CCRN,

    (Family Nurse Practitioner)
    1. St. Joseph’s Hospital and Medical Center, Phoenix, Arizona
    2. Department of Trauma, St. Joseph’s Hospital and Medical Center, Phoenix, Arizona
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  • Margaret Yancy RN, MS, WHNP/ANP-C

    (Clinical Associate Practitioner3 and Women’s Health Nurse Practitioner7)
    1. College of Nursing and Healthcare Innovation, Arizona State University, Phoenix, Arizona
    2. Maternal Outreach Mobile, St. Joseph’s Hospital and Medical Center, Phoenix, Arizona
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Katherine J. Kenny, RN, MS, ANP, APRN, BC, CCRN, St. Joseph’s Hospital and Medical Center, 350 W. Thomas Road, Phoenix, AZ 85013.
Tel: 602-406-3615; Fax: 602-798-0059;
E-mail: kjkenny@cox.net

Abstract

Purpose: To provide an overview of the development and implementation of a peer review process for advanced practice nurses (APNs) based on critical incidents that provide meaningful evaluation of practice and meets the needs of APNs across multiple care specialties and practice situations.

Data sources: A review of the literature and evaluation of the existing peer review process currently in place at a large tertiary care facility.

Conclusions: Peer review is central to self-regulation and professional practice for APNs. It has been proposed that APNs of similar rank and clinical expertise should participate in peer review. APN peer review and evaluation have traditionally existed as a component of performance evaluation, evaluation of practice patterns, and compliance monitoring, and to evaluate quality indicators. We found no examples of peer review in the context of evaluating a critical incident in the literature. The APN Peer Review Committee and the review process were developed at our institution to provide peer input and communication to all credentialed APNs in incidents regarding appropriateness of care and scope of practice.

Implications for practice: APNs must assure that they have a voice in the peer review process. Representation by peers of similar specialty and rank is an important component in the peer evaluation process. The establishment of the APN Peer Review Committee served this purpose for our institution.

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