Date of Award

Fall 2018

Project Type

Clinical Doctorate

College or School




Program or Major


Degree Name


First Advisor

Pamela DiNapoli

Second Advisor

Rebecca Freeman


Introduction: The purpose of nursing peer review is to assess the quality of nursing care against established standards, identify strengths and weaknesses in practice, and identify knowledge gaps. Studies of nurse peer review predominantly focuse on staff nurse attitudes and knowledge after an educational intervention and barriers to implementation. Frontline nurse leaders (FLNL) can influence adoption of new practices such as peer review.

Purpose: The purpose of this project was to engage frontline nurse leaders in a role specific peer review program, preparing them to support their staff in the implementation of peer review in the future and providing an opportunity for professional development through peer review.

Methods: FLNLs helped to develop practice standards for peer review. They attended a presentation on peer review implementation and participated in peer review with a FLNL colleague on their units, using a process similar to that planned for clinical nurses. They completed a pre and post-assessment of their confidence in and perceptions of peer review process.

Results: Paired t-Tests showed a statistically significant improvement in both confidence in implementation of peer review and perceptions of peer review for the participants. Anecdotally, FLNL found value in participating in a new process they were expected to support, prior to staff implementation.

Discussion: Limitations included the lack of valid tools for assessing FLNL’s peer review confidence and increased patient census, limiting participation of FLNL in the project. The experience of FLNLs will be used to improve the process of implementation for clinical nurses.