Date of Graduation

Summer 8-4-2026

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)

College/School

School of Nursing and Health Professions

Program

Kaiser cohort MSN capstone

First Advisor

DAVID AINSWORTH

Second Advisor

RAYNE SORIANO

Abstract

Abstract 

Background: Labor and Delivery (L&D) units require effective communication, speaking up, and team learning to support safe care. Psychological safety informed this quality improvement project as a contextual strategy to strengthen peer feedback engagement.  

Problem: Peer feedback participation among eligible L&D registered nurses at a large acute care hospital in Santa Clara, California, was 14.29% (N = 112) below the 30% project target and 80% organizational target. Low participation limited routine feedback for professional development, recognition, and team learning.

Interventions: Interventions included psychological safety education, peer feedback reinforcement, workflow integration, platform navigation support, dedicated completion time, and unit champions. PlanDo-Study-Act cycles refined implementation based on staff feedback, participation trends, and workflow barriers.

Outcome Measure:  The sole outcome measure was peer feedback participation, defined as the percentage of eligible L&D nurses who submitted peer feedback through the organizational platform. Process and balancing considerations included education completion, workflow/reinforcement implementation, staff time, and workflow burden. The psychological safety survey was diagnostic only.  Results: Peer feedback participation increased from 14.3% to 21.4%by April 1, 2026, representing a 7.1 percentage-point improvement. Subsequent unit-level data were unavailable because of an organizational platform reporting issue. Contextual findings from the 2026 Nurse Excellence Survey demonstrated improvements in RN-to-RN Teamwork (0.26) and Interprofessional Relationships (0.26).

Conclusion: A low-resource, systems-based intervention addressing cultural and structural barriers improved engagement within a high-acuity L&D microsystem. Sustaining gains requires workflow integration, visible participation data, champions, and leadership reinforcement. Findings support nursing professional development, teamwork, patient safety, and workforce well-being.

Keywords: Psychological safety; peer feedback; quality improvement; nursing professional development; patient safety. 

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