Page 15 - 2017 Nursing Annual Report | Summa Health

Once the group of staff leaders was convened, case Some examples of follow-up include dissemination of the
review forms were created and edited based on “Pearls of Peer Review,” in which the themes of the case
benchmarking with the help of System Director of – strengths and/or weaknesses – are shared with all staff
Performance Improvement and Quality Assurance Trish so that we can learn lessons from these reviews. If the
Enos, BS, BSN, RN, CPHQ. Intrapartum Nursing Peer reviews and lessons are simply kept in a vacuum and not
Review meetings are typically one hour in length and shared, then a valuable resource is lost that could have
occur every other month with flexibility to meet more or offered guidance and informed future practice. If follow
less frequently based on need. Cases are brought forward up is required for staff involved in the case, it is meant to
for nursing peer review in one of several ways: be non-punitive. Finally, interdisciplinary collaboration and
communication is also supported through this endeavor,
• Referral from SafeCARE® as some cases are referred from the departmental peer
review for nursing input. Likewise, system and provider
• Referral from personnel (nurses, resident physicians, input is occasionally needed following the nursing peer
providers) review, so cases may be sent back to the department for
follow up.
• Referral from Obstetrics Departmental Peer Review if
a case has a nursing consideration component that is Since 2014, the Intrapartum Nursing Peer Review
appropriate for nursing peer review Committee has reviewed more than 30 cases. Key lessons
tend to focus on communication and documentation in
• Referral from Quality based on outcome metrics order to highlight for obstetric nurses the importance
and state and national reporting guidelines (Ohio of taking credit for the care that is provided, and to “tell
Department of Health and The Joint Commission) the story” of the woman’s labor and birth experience
through that documentation. The committee itself has
Once a case is received, it is sent to the committee ahead also evolved, as more novice intrapartum nurses are now
of time for individual peer review, so that everyone comes encouraged to attend and participate as a method of
to the meeting prepared to discuss the case, outcomes, learning and quality improvement.
and subsequent findings. Meetings are spent with a
recap of the events of the case, followed by roundtable Since 2014, Barberton Campus staff also have joined the
discussion regarding the nursing actions during the care Akron Campus nurses for these meetings, bringing its
provided. Discussions focus on the nursing process: own cases; however the participation has been sporadic.
assessment, nursing diagnosis, planning, intervention and Barriers existed due to travel and time constraints. As
evaluation. Consideration is given to the standard of care a result, earlier this year, Summa Health Barberton
as determined by policies and procedures, unit culture, reintroduced an intrapartum nursing peer review, which
state and national “best practices,” bundle adherence, and now continues at the Barberton Campus on a monthly
what the committee members – as senior staff nurses basis, following the same template as has been successful
– would do in the same or similar circumstances. Also in Akron.
discussed are system factors that contribute in either a
positive or negative way to the performance of nursing Overall, the Intrapartum Nursing Peer Review Committee
care. Essential to these meetings is the documentation plays a critical role in Summa’s self-assessment of
that is present, or absent, from the medical record. nursing care, quality improvement and interdisciplinary
collaboration, and ensures that we continue to provide
As the committee discusses a case, themes generally the best care to all of the women, newborns and families
emerge, such as assessment integration, interventions that we serve.
applied, communication, and documentation. With many
cases, no further action is required. Nonetheless, follow-
up does occur after every intrapartum nursing peer review
committee meeting.

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