Other Titles

Nursing Practice Excellence Committee (NPEC): Setting the “Right Table” for NPECable Practice Decisions [Title Slide]

Abstract

Purpose: The Nursing Practice Excellence Committee (NPEC) initiative is intended to provide a structure for nurses to leverage their expertise in driving nursing practice, care quality and patient safety improvements. NPEC fortifies professional governance by setting the “right table” for decision-making.

Background: This Magnet-designated organization recognized that sustaining the Magnet nursing culture of excellence requires consideration and uptake of current best practices and structures. Accordingly, NPEC was designed to be a systematic, evidence-based approach to incident-based practice reviews that embeds and reinforces Professional Governance and Exemplary Professional Practice. NPEC positions bedside nurses as subject matter experts and leaders to translate evidence-based strategies into solutions.

Method: NPEC is based on best practices: Just Culture, Root Cause Analysis, High Reliability, Action Hierarchy, and Human Factors Engineering. Reviews are triggered by reported quality/safety issues. A Just Culture Algorithm is used to decide between NPEC evaluation or individual performance management. Referred cases convene NPEC meetings where unit-based shared nursing governance (SNG) council members, the Magnet/Professional Practice Coordinator, the Quality Nurse, nurse educators, and case-involved nurses participate. Consensus-driven recommendations for action are generated and assigned. Summarized reviews are then forwarded to nursing leaders and SNG councils for alignment and dissemination.

Results: NPEC was developed at a small Magnet-designated hospital in the midwest. Over the past year after implementation, the utility and value of NPEC were evaluated using data that included count and distribution of event submission categories, count and distribution of recommended actions/interventions by strength according to the Hierarchy of Actions, and by date when assigned actions were completed. Data were monitored and analyzed for trends. A large non-Magnet academic hospital within the same system has also adopted and tailored NPEC with equally successful outcomes, proving the framework’s versatility.

Conclusions: Professional governance requires nursing accountability in four domains: practice, quality, competence and knowledge. NPEC empowers nurses at all levels and in all roles to practice autonomy and leadership, concretely demonstrating the Magnet culture of nursing excellence through tangible outcomes.

Notes

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References:

1. Ethington, S. J., Edwards, J. M., & Reames, C. D. (2024). Clinical Nurse Peer Review: A Process That Works for the Nurse and the Organization. The Journal of Nursing Administration, 54(7-8), 416–421. https://doi.org/10.1097/NNA.0000000000001450

2. Garner, J. K. (2015). Implementation of a Nursing Peer-Review Program in the Hospital Setting. Clinical Nurse Specialist, 29(5), 271–275. https://doi.org/10.1097/nur.0000000000000149

3. Herrington, C. R., & Hand, M. W. (2019). Impact of Nurse Peer Review on a Culture of Safety. Journal of Nursing Care Quality, 34(2), 158–162. https://doi.org/10.1097/ncq.0000000000000361

4. Institute for Healthcare Improvement. (2025). RCA2: Improving Root Cause Analyses and Actions to Prevent Harm. Ihi.org. https://www.ihi.org/library/tools/rca2-improving-root-cause-analyses-and-actions-prevent-harm

5.Kim, B. B., & Yu, S. (2021). Effects of Just Culture and Empowerment on Patient Safety Activities of Hospital Nurses. Healthcare, 9(10), 1324. https://doi.org/10.3390/healthcare9101324

6. Murray, J. S., Clifford, J., Larson, S., Lee, J. K., & Sculli, G. L. (2022). Implementing just culture to improve patient safety. Military Medicine, 188(7-8), 1596–1599. https://doi.org/10.1093/milmed/usac115

7. Roberts, H., & Cronin, S. N. (2017). A Descriptive Study of Nursing Peer-Review Programs in US Magnet® Hospitals. JONA: The Journal of Nursing Administration, 47(4), 226–231. https://doi.org/10.1097/nna.0000000000000469

8. Thomas, M. B., McDermott, E., Green, D., & Benbow, D. (2020). Evaluation of Nursing Practice-Breakdown: A Resource for Peer Review. Journal of Nursing Regulation, 11(1), 42–47. https://doi.org/10.1016/s2155-8256(20)30060-0

9. UC Davis PSNet Editorial Team. (2019, September 15). Human Factors Engineering | PSNet. Ahrq.gov. https://psnet.ahrq.gov/primer/human-factors-engineering

10. UC Davis PSNet Editorial Team . (2024, September 15). High Reliability. Ahrq.gov. https://psnet.ahrq.gov/primer/high-reliability

11. van Baarle, E., Hartman, L., Rooijakkers, S., Wallenburg, I., Weenink, J.-W., Bal, R., & Widdershoven, G. (2022). Fostering a Just Culture in Healthcare organizations: Experiences in Practice. BMC Health Services Research, 22(1). https://doi.org/10.1186/s12913-022-08418-z

Description

Nursing Practice Excellence Committee (NPEC) is professional governance in action! Learn how this evidence-based, systematic, collaborative process engages and empowers nurses to lead improvements in nursing practice, quality, competence and knowledge. Discover how NPEC has transformed the incident-based review process experience into a action-oriented, learning and solutions-focused (and FUN) experience!

Author Details

Cristina L. Ritzema, MPH, BSN, RN, CHES, NPD-BC - CHI Health St. Elizabeth, Lincoln, NE USA

Sigma Membership

Phi Gamma (Virtual)

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Other

Keywords:

Instrument and Tool Development, Interprofessional and Interdisciplinary, Acute Care, Excellence, Nursing Practice, Professional Practice, Medical Quality Control, Quality of Service

Conference Name

37th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Toronto, Ontario, Canada

Conference Year

2026

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2026-09-27

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Nursing Practice Excellence Committee: Setting the “Right Table” for NPEC-Able Practice Improvement

Toronto, Ontario, Canada

Purpose: The Nursing Practice Excellence Committee (NPEC) initiative is intended to provide a structure for nurses to leverage their expertise in driving nursing practice, care quality and patient safety improvements. NPEC fortifies professional governance by setting the “right table” for decision-making.

Background: This Magnet-designated organization recognized that sustaining the Magnet nursing culture of excellence requires consideration and uptake of current best practices and structures. Accordingly, NPEC was designed to be a systematic, evidence-based approach to incident-based practice reviews that embeds and reinforces Professional Governance and Exemplary Professional Practice. NPEC positions bedside nurses as subject matter experts and leaders to translate evidence-based strategies into solutions.

Method: NPEC is based on best practices: Just Culture, Root Cause Analysis, High Reliability, Action Hierarchy, and Human Factors Engineering. Reviews are triggered by reported quality/safety issues. A Just Culture Algorithm is used to decide between NPEC evaluation or individual performance management. Referred cases convene NPEC meetings where unit-based shared nursing governance (SNG) council members, the Magnet/Professional Practice Coordinator, the Quality Nurse, nurse educators, and case-involved nurses participate. Consensus-driven recommendations for action are generated and assigned. Summarized reviews are then forwarded to nursing leaders and SNG councils for alignment and dissemination.

Results: NPEC was developed at a small Magnet-designated hospital in the midwest. Over the past year after implementation, the utility and value of NPEC were evaluated using data that included count and distribution of event submission categories, count and distribution of recommended actions/interventions by strength according to the Hierarchy of Actions, and by date when assigned actions were completed. Data were monitored and analyzed for trends. A large non-Magnet academic hospital within the same system has also adopted and tailored NPEC with equally successful outcomes, proving the framework’s versatility.

Conclusions: Professional governance requires nursing accountability in four domains: practice, quality, competence and knowledge. NPEC empowers nurses at all levels and in all roles to practice autonomy and leadership, concretely demonstrating the Magnet culture of nursing excellence through tangible outcomes.