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Introduction
Most top multi-level and multi-nation organizations have performance appraisals as their essential factors in order to achieve goals (Shahriari,, et al. 2013). These performance appraisals are in line to ensure that competent staff are selected and trained to meet the mission of the organization. The key customers of the organization are also taken into consideration to assess employee strength and weaknesses (Shahriari,, et al. 2013). As per recent norms, nurses should be held responsible for any deficient in the healthcare system with respect to any setting. Furthermore, nurses in hospitals are also responsible for the overall patient outcomes and organizational infrastructure. There are specific standards and regulations that been set for nurses to prepare, train, and perform in a multi-level organization such as the American Nursing Credentialing Center Magnet Recognition Program for Nursing Excellence and American Nurses Association (Kourkouta, & Papathanasiou. 2014).
Self-Evaluation for Staff Nurses
The self-evaluation for staff nurses are to be submitted to nurse managers during the quarterly or annual review. The basics of self—evaluation is that the nurse to be evaluated and the evaluation tool utilized by the concerned department are the same. Nurse manager and staff nurses should have the same evaluation criteria. The self-evaluation helps in improving nurse performance by assessing deficiency in nurses, followed by counselling sessions and a plan for improvement. The improvement criteria is assessed by the nurse manager/head. Deficiency improvement should not be disclosed in the evaluation form. It is essential to assess disputes between the manager and the staff nurse in order to improve productivity and enhance performance to achieve goals. The main objective of the self-evaluation is to build trust between staff and manager. This helps in maintaining a professional environment with respect to interpersonal growth (Li, Guan, Chang, & Zhang. 2014).
Off-the-Shelf methods: Considerations for Licensed Vocational Nurses (LVNs)
Nurse assistants and administrators are involved in different business metrics of the organization in order to facilitate business growth and improve health outcomes. Furthermore, the cost accounting of the organization is a critical factor that should be assessed and evaluated by nurse managers (Yuan, et al. 2013). Most organizations have implemented a computerized system that would help in assessing individual nurse performance with respect to mission and vision of the organization. The computerized system of evaluation would also help nurse leaders to assess performance and change staff nurse profiles based on key strengths and weaknesses. The tech-based evaluation would help nurse managers to assess the cost associated with the rate of infections as an example. The cost associated with infections is an indicator for nurse’s inefficiency in quality control and patient welfare. In this manner electronic systems can be implemented for accurate appraisal of staff or nurse assistants within the organization (Yuan, et al. 2013).
Peer Review: A Continuous Process for Nurse managers, assistants, and staff
The concept of peer review is new in the nursing fraternity. However, peer review could have a significant impact in improving productivity and providing insights for nurse managers, staff nurses, and assistant nurses. The peer review process is also beneficial for licensed vocational nurse (LVN) (Bahreini, et al. 2012). The process of peer review is based on the assessment and monitoring of quality of nursing care against the standards of professional care/practice by registered nurses within the same department. As per the ANA definition for peer review, ‘The process of assessment and judgement by nurses in order to evaluate the quality of care in line with the actual standard of care practice.” The first peer review process for nursing appraisal was reported in 1980’s (Bahreini, et al. 2012)
The peer review process for nurses has been incorporated by American Nurses Credentialing Centre for nurse appraisal across various healthcare systems. The ANCC has also introduced the concept of shared-governance models within the nursing fraternity for the appraisal systems. These appraisal methods have been well incorporated in hospital care settings.
The nurse outcomes have improved with the implementation of the peer-review strategy and should be addressed to nurse managers and LVNs. The peer interaction and appraisal is ideal for all groups of nurses since it develops a sense of responsibility and professionalism. Some of the key outcomes that have been achieved through peer review include: Accountability, nurse retention, increased professionalism, autonomy, and improved communication skills. Nurse managers and assistants believe in the process by including multiple sources (peers) that would inculcate a sense of completeness, reliability, and validity (Bahreini, et al. 2012)
The peer interaction and assessment by nursing staff within the same organization helps build relationships and increase transparency in the process (Bahreini, et al. 2012). Nurse administrators believe that peer interactions help improve the patient care and health outcomes. There is no body of evidence on the direct impact of health outcomes and peer review appraisals in nursing. Lastly, the peer review process should be considered within the appraisal system of all healthcare systems in order to achieve the goals of the organization by inculcating an autonomy in culture and professionalism (Bahreini, et al. 2012).
Constructive Feedback in Nursing
Performance feedbacks are based on the type of organization. However, constructive feedback has become the need of the hour in the nursing profession. Constructive feedback is best for nurse managers and nurse leaders who are headed by the upper management of the organization. This appraisal method has become a norm in the nursing industry since it focuses on key factors that would have a positive impact on the employee and benefit the organization. The key factors that should be considered in constructive feedback include:
Issue-focused and information-specific: The management should address the nurse managers and leaders by either criticizing a decision/work format or complementing the same with a praise in order to boost morale. However, in this method, the issue and information conveyed have to be specific (Wilkinson, et al. 2013).
Direct message conversion: The management have to directly address key information and not divert the key concept of the discussion. All key information on the performance have to be conveyed directly and professionally
Avoidance of mixed messages: The constructive feedback is based on the direct impact of praise or criticism to nurse managers and it is highly recommended to avoid mixed feelings or messages during the appraisal or feedback (Wilkinson, et al. 2013).
Disclose observations and not interpretations: The management should focus on the observations made and not the opinions/interests or interpretations to evaluate the performance of the nurse manager. Observations are considered to be non-judgemental and factual compared to interpretations (Wilkinson, et al. 2013).
Other key factors that should be addressed in constructive feedback as an appraisal method for nurses include time, frequency, manner, content, and professionalism. It is one of the most fundamental aspects of appraisal in the nursing fraternity (Wilkinson, et al. 2013).
Overcoming Pitfalls
The concept of appraisals and different models and methods to execute for the improvement of the healthcare system and nursing fraternity have also been criticized (Reviriego, et al. 2014). Nurse managers and nurse assistants have ego and behavioural issues that such methods of appraisal are bound to create discrepancies and foot holes (Reviriego, et al. 2014).
Nurse managers and nurse staff have a different perspective towards achieving goals and objectives of the organization. However, there could be instances when nurse mangers would not support criticism or negative feedback from peers or management (Reviriego, et al. 2014). In such cases, an innovative or alternate appraisal method should be adapted that would not only hurt the sentiments of senior nurses but would also invoke a sense of pride and responsibility towards the updated appraisal system (Reviriego, et al. 2014).
Nurse considerations on appraisals and performance
The entire appraisal process should be addressed by the nursing staff and any discrepancies should be resolved at the earliest. Based on current evidence, peer review and constructive feedback have been the top most opted appraisal methods for nurses across various healthcare settings. Technological advancements have been observed in the appraisal system in order to facilitate a unique, interactive, structured, and organized platform for nurses in the healthcare system. Key concepts that have been identified in each sector of the aforementioned appraisal methods include nurse issue identification, process, strategy, outcome, review, and resolution to key issues associated with appraisal and performance (Shahriari,, et al. 2013).
Nurse managers along with nurse staff, assistants, and LVNs should have a shared-decision making environment accompanied with a tested and validated appraisal method for improved productivity and performance (Shahriari,, et al. 2013). Each of these groups have specific needs, demands, and issues that need to be addressed in a customized manner. It is through the appraisal methods that these key factors are identified among nurses. Thus, the appraisal methods form the backbone of productivity, performance, and improved patient care/health outcomes in the nursing profession (Shahriari,, et al. 2013).
References
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