Attachment K-Peer Review Tool.pdf
PDF 83 KB Posted
- Attached to
- Breastfeeding Peer Counseling Services
- Solicitation number
- 25RFP-25-0904004-005
- Issued by
- Kingsbury County, South Dakota
About this file
This is a Peer Review Tool form used by the South Dakota Department of Health WIC Program for evaluating breastfeeding peer counselors' communication and counseling techniques. The form outlines six key counselor expectations to be rated as "Always," "Sometimes," or "Never," including: using appropriate names, engaging mothers through open-ended questions, validating feelings, offering solutions, providing follow-up/referrals, and documenting in WIC-IT.
The evaluation criteria focuses heavily on the implementation of a 3-Step counseling strategy, appropriate information sharing without overwhelming participants, maintaining scope of practice, and proper documentation of breastfeeding-related conversations and follow-ups. The form specifically excludes evaluation of certain administrative tasks like contact timing after referrals and sending class announcements. This tool appears designed to support quality improvement of peer counseling services while providing learning opportunities for both the reviewer and counselor being reviewed.
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Text version
Your Name reviewing Their Name Peer Review Tool
Purpose: To review a fellow peer counselor’s communication and counseling techniques in an effort to help her improve her skills, while potentially learning something for my own counseling strategies.
Participant Name & ID #:
Date:
Counselor Expectations Always Sometimes Never Comments (Positive feedback, what I would have done differently)
1. Peer Counselor uses the mother’s (and baby’s name, if appropriate).
2. Peer Counselor engages the mother through open-ended questions and uses probes appropriately to better understand the mother’s situation.
3. Peer Counselor validates the mother’s feelings through affirmation and ends the counseling session on a positive note.
4. Peer Counselor offers simple solutions or strategies to address the mother’s concerns.
5. Peer Counselor offers appropriate follow-up and referrals.
6. Peer Counselor appropriately documents in WIC-IT.
Ideas on What to Look For:
#2/3:
● Was the 3-Step counseling strategy utilized?
● How would you have counseled differently?
#4:
● Was the information shared helpful/pertinent and easy to understand?
● Are shortcuts easy to understand?
● Are routine shortcuts edited to be personalized to the participant’s situation?
Attachment K
● PC isn’t ‘overloading’ the participant with information.
● Did the participant seem receptive to information shared?
#5:
● PC followed up within an appropriate time frame after a participant stated concerns and PC walked through how to help the situation.
● PC stayed within their scope of practice.
● Referred to the appropriate person(s) when needed.
#6:
● Breastfeeding notes were made for all back-and-forth conversations.
● Breastfeeding notes were made when attempting to follow-up on a breastfeeding issue.
● Do the breastfeeding notes provide WIC staff with all the necessary information pertinent to the participant’s breastfeeding issue/situation?
What You DO NOT Need to Look For:
● If the PC contacted the participant within an appropriate time after a referral.
● If all required contacts are made/sent.
o If BF class or support group announcements are sent.
File details come from the government source that posted it. Updated .