Framework RN Peer Input Tool for Annual Evaluation: Therapeutic Relationships Peer feedback for (RN name): Directions: Evaluatee to send behavior portions to peers who you would like feedback from Clinical Skills and Knowledge is to be completed by another RN Peers should indicate within the last column the level they feel is appropriate for the Evaluatee on each row Peers are encouraged to support their views with concrete examples Peers should complete the peer review within 7 Days and return electronically to the Manager/Designee and Evaluatee DOMAIN: Therapeutic Relationships: An intentional interactive relationship with patients and families that is caring, clear, boundaries, positive and professional. It encompasses the philosophy of the institution, empowerment of the care givers and empowerment of the patient/family. Peer should designate A C D E appropriate level below Therapeutic Communication Recognizes how the Possesses clarity on Consistently role Intuitively uses nurse: patient/family ones own values and models individualized expert therapeutic relationship impacts how they effect therapeutic communication with the patient experience interactions, communication based patient/family. Introduces self as a relationships and on patient and family Shares and promotes Registered Nurse and boundary setting. needs. collaborative describes role. Individualizes Initiates consultation / approach to patient Consistently wears communication based leadership with the and family care identification on assessment of the healthcare team to Establishes open patients and families share and promote communication collaborative approach to patient and family care. Empowerment Patient/Family – Recognizes the need Incorporates Invites patients and Maximizes for patient and family patient/family in families to actively patient/family to participate in care planning and participate in plan of participation in Seeks help as implementing care care to foster growth decision-making and appropriate to assess and competence. goal setting along the readiness for continuum of care participation in care Compassion Actively listens to Demonstrates Plans and provides Intuitive patient/family empathy in nursing care that understanding of concerns in a interactions with promotes intentional patient/family respectful manner patients/families caring. experience and is Shows kindness and proactive in caring with providing creative patient/families approaches to optimize comfort and support. Advocacy and Ethics
Framework RN Peer Input Tool for Annual Evaluation: Therapeutic Relationships Peer feedback for (RN name): Directions: Evaluatee to send behavior portions to peers who you would like feedback from Clinical Skills and Knowledge is to be completed by another RN Peers should indicate within the last column the level they feel is appropriate for the Evaluatee on each row Peers are encouraged to support their views with concrete examples Peers should complete the peer review within 7 Days and return electronically to the Manager/Designee and Evaluatee DOMAIN: Therapeutic Relationships: An intentional interactive relationship with patients and families that is caring, clear, boundaries, positive and professional. It encompasses the philosophy of the institution, empowerment of the care givers and empowerment of the patient/family. A C D E Peer should designate appropriate level below Therapeutic Communication Recognizes how the nurse: patient/family relationship impacts the patient experience Introduces self as a Registered Nurse and describes role. Consistently wears identification Establishes open communication Possesses clarity on ones own values and how they effect interactions, relationships and boundary setting. Individualizes communication based on assessment of the patients and families Consistently role models individualized therapeutic communication based on patient and family needs. Initiates consultation / leadership with the healthcare team to share and promote collaborative approach to patient and family care. Intuitively uses expert therapeutic communication with patient/family. Shares and promotes collaborative approach to patient and family care Empowerment – Patient/Family Recognizes the need for patient and family to participate in care Seeks help as appropriate to assess readiness for participation in care Incorporates patient/family in planning and implementing care Invites patients and families to actively participate in plan of care to foster growth and competence. Maximizes patient/family participation in decision-making and goal setting along the continuum of care Compassion Actively listens to patient/family concerns in a respectful manner Shows kindness and caring with patient/families Demonstrates empathy in interactions with patients/families Plans and provides nursing care that promotes intentional caring. Intuitive understanding of patient/family experience and is proactive in providing creative approaches to optimize comfort and support. Advocacy and Ethics
rn_Framework_Peer_Feedback_Therapeutic_Relationships.docx