Performance Appraisal in Nursing


Performance appraisal is critical in nursing and is widely applied throughout the country to improve motivation and job outcomes. Although performance appraisal is associated with additional costs, it should be mandatory for all healthcare institutions. With the lack of managerial attention, employees tend to work less responsibly and often feel underestimated and lose motivation. Therefore, some healthcare managers support the idea that performance appraisals should be eliminated from the nursing work setting. However, it is a wrong approach since it will negatively influence the performance of nurses. This paper aims to argue that the performance appraisal is vital for the nurses’ performance and motivation.

What is Performance Appraisal?

Performance appraisal is nursing to ensure that nursing practise meets accepted standards. Independent evaluation also implies that each nurse can receive feedback on their work, contributing to the improvement of competence and professional growth. Guidelines for peer review of nurses were first published in 1988 by ANA. According to these recommendations, the assessment should be based on evidence that could characterize the nurse’s work. Anonymous reviews are still widely used to assess nursing practice (Murphy et al., 2019). However, scientists are developing new approaches, such as the personal assessment of nurses with the provision of individual feedback, since the effectiveness of this approach is many times higher than anonymous assessment. Therefore, it is clear that performance appraisal is a recent but well-established practise that has proven to be effective in enhancing the effectiveness of nurses.

Why Does the Performance Appraisal Matter?

Most academics share the view that performance appraisal improves the quality of care and healthcare outcomes. Therefore, scholars everywhere recommend that managers implement employee performance appraisal practices. At the same time, there is a link between management awareness of the performance appraisal and improving the quality of performance (Moradi et al., 2017). Performance assessment is good practice, but it requires careful and responsible management. Scientists conducted a study involving 75 managers and 313 nurses, which found that managers tend to be more optimistic about appraisal performance than nurses. These results suggest that the certification schemes may need to be improved, and these improvements can be developed based on the feedback provided by nurses on system deficiencies. In other words, although the use of the performance appraisal at the workplace is a positive trend, the assessment scheme deserves special attention since the fairness of the performance appraisal is a fundamental component of this practice.

Attention to the quality of assessment and assessment schemes is significant given that nurses’ perceptions of the performance appraisal can have both positive and negative effects on the job outcomes. Scientists note that the perceptions impact organizational commitment, work performance, turnover intention, job motivation, and job satisfaction in varying ways (Ibrahim & Abdelaziz, 2019). In general, performance assessments positively affect productivity and emotional commitment and moderately on turnover intentions. The scholars recommend that “the nursing evaluator should use a standardized format for assessing nursing performance; it should be specific, accurate and pertinent to the work and responsibilities of nurses” (Ibrahim & Abdelaziz, 2019). This approach will help prevent subjectivity and overcome errors during the assessment. The researchers also recommend mandatory feedback so that nurses can critically assess their progress. These research findings allow generalizations and suggest that performance appraisal should be standardized and evidence-based to avoid bias and be perceived positively by nurses.

Performance appraisals have a powerful impact on improving job satisfaction and quality performance. At the same time, scientists note a negative attitude towards fairness and accuracy of assessments, which leads to the formalization of perception and a decrease in the positive effect of practice (Nutakor, 2019). In such a case, the scholars recognize that the performance appraisal can become a routine, ritualistic procedure that will harm the productivity and motivation of nurses and the organization as a whole. After examining interviews conducted with 20 participants, the researchers found that the nurses’ perception of performance appraisal is an essential component of HR management. Scientists recommend that such an assessment must be carried out, taking into account “the basic knowledge and contribution of employees to the design and assessment process” (Nutakor, 2019, p.). If leaders heed this advice, they will notice social changes, such as a more profound understanding and perception of the performance appraisals and improved fairness in assessment.


Thus, it was discussed why the performance appraisal is vital for the nurses’ performance and motivation. The recommendations to improve the practice were also provided. The performance appraisal should be made in the healthcare organizations since it proved to be effective in increasing job performance and motivation and decreasing turnover intentions. However, there are concerns regarding the performance appraisal quality that sometimes can be too formalistic, routine, or subjective. Therefore, the scholars generally recommend that managers study the practice, avoid subjectivity by using fact-based evaluation, and follow the assessment’s norms and standards. Most importantly, the nurses should participate in the performance appraisal design development and have an opportunity to provide feedback regarding the performance appraisal quality, fairness, and potential errors.


Ibrahim, I. A., & Abdelaziz, H. G. Nurses’ perception of performance appraisal and its effect on their work outcomes. International Journal of Novel Research in Healthcare and Nursing, 6(2), 1700-1710. n.d.

Moradi, T., Mehraban, M. A., & Moeini, M. (2017). Comparison of the perceptions of managers and nursing staff toward performance appraisal. Iranian Journal of Nursing and Midwifery Research, 22(2), 128.

Murphy, J., Lung, C., Boerger, J. A., & Powers, J. (2018). Comprehensive nursing peer review: Our voice, our practice, our growth. Nursing Management, 49(8), 49-33.

Nutakor, S. D. A. (2019). Employee perceptions of fairness in performance appraisals and job satisfaction. Walden Dissertations and Doctoral Studies.

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