PEER AUDIT AND FEEDBACK: A DOCUMENTATION-FOCUSED QUALITY IMPROVEMENT PROJECT

Background: The most common cause of sentinel events is ineffective communication among the healthcare team. Nurses’ documentation of communication, including documenting the notification of critical laboratory results (CLR), is important to ensure that information is accessible. Growing evidence supports the potential of ongoing peer review with feedback as a quality improvement (QI) intervention for documentation.
Purpose: This project sought to implement and evaluate a peer audit and feedback intervention focused on CLR documentation.
Methods: The project occurred on two units of a tertiary medical center where compliance for documentation of CLR was below goal for several years. The intervention was timely peer audit and feedback of CLR events, with a post-project survey to gain nursing perspectives on the process. Data collected included overall compliance rate for CLR documentation, data from the peer audits, and post intervention survey responses.
Results: The improvement in CLR documentation compliance was not statistically significant; however, results were clinically significant as compliance improved on one unit from 6.10% to 9.6% (57.4% improvement). Survey results showed overall positive perceptions of peer audit and feedback as a QI tool, and the intervention was perceived as being non-punitive and helpful for improving practice.
Conclusion: Results support continued examination of the peer audit and feedback process, and its potential for QI in nursing documentation. Future projects should consider strategies to address limited time for nursing staff to engage in quality improvement projects.