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accountability, clinical nurse specialist, peer review



  1. Semper, Julie MSN, RN, CNS
  2. Halvorson, Betty MSN, RN, ACNS-BC
  3. Hersh, Mary PhD, RN
  4. Torres, Clare BSN, RN
  5. Lillington, Linda PhD, RN


Purpose: The aim of the study was to describe the clinical nurse specialist role in developing and implementing a staff nurse education program to promote practice accountability using peer review principles.


Background: Peer review is essential for professional nursing practice demanding a significant culture change. Clinical nurse specialists in a Magnet(R)-designated community hospital were charged with developing a staff nurse peer review education program.


Rationale: Peer review is a recognized mechanism of professional self-regulation to ensure delivery of quality care. The American Nurses Association strongly urges incorporating peer review in professional nursing practice models. Clinical nurse specialists play a critical role in educating staff nurses about practice accountability.


Description: Clinical nurse specialists developed an education program guided by the American Nurses Association's principles of peer review. A baseline needs assessment identified potential barriers and learning needs. Content incorporated tools and strategies to build communication skills, collaboration, practice change, and peer accountability.


Outcome: The education program resulted in increased staff nurse knowledge about peer review and application of peer review principles in practice.


Conclusion: Clinical nurse specialists played a critical role in helping staff nurses understand peer review and its application to practice.


Implications: The clinical nurse specialist role will continue to be important in sustaining the application of peer review principles in practice.