The Influence of performance appraisal practices, feedback, and appraisal process, on nurses’ job performance: a case of Kenyatta National Hospital

Abstract

Maximizing organizational performance is the main cornerstone for an organization's existence. It establishes a higher competitive edge among existing and potential clients. Performance Appraisal is a process used to review how employees apply their knowledge and their skills to add value to the organization. Performance appraisal helps an employee to know how they perform and identify areas that require improvement. It also helps the organization to disseminate its main objectives to the employees through this process and enhances employees’ participation and commitment. However, since the introduction of staff evaluation at Kenyatta National Hospital, a comprehensive study has not been conducted to determine the overall influence of performance appraisal on the nursing staff's job performance. The main objective of this study was to determine the influence of performance appraisal on nurses’ job performance using a case study of Kenyatta National Hospital. The study design was quantitative, using a descriptive cross-sectional design. The study population consisted of staff nurses and nurse managers working in various departments such as medical, surgical, and the Kenyatta Prime Care Centre, among others. Data were collected using semi-structured questionnaires after obtaining informed consent. Collected data were analyzed, and findings were presented in tables and figures. Chi-square tests were used to determine the relationship between various study variables. The findings revealed that demographic factors significantly affected nurses’ performance. Years of experience showed a strong positive relationship with job performance (r = 0.962, p < 0.001), while age, designation, department, and employment type was associated with performance, with effect sizes ranging from η² = 0.07 to 0.18. Permanent staff and mid-career nurses demonstrated higher performance compared to contract staff and less-experienced counterparts. Performance appraisal practices was positively associated with job performance, particularly when appraisal criteria were clear, and discussions with supervisors were interactive. Chi-square analysis showed a significant relationship between clear appraisal criteria and performance (χ² = 18.73, df = 4, p = 0.001), and feedback and performance (χ² = 12.84, df = 4, p = 0.012), while the frequency of appraisals alone did not significantly influence performance (χ² = 5.26, df = 4, p = 0.261). Multiple regression analysis was conducted to examine the influence of performance appraisal practices, performance appraisal feedback outcomes, and performance appraisal process on nurses' job performance. The overall model was statistically significant, F(3,360) = 134.9, p < .001, and explained 52.9% of the variance in job performance outcomes (R² = 0.529). Performance appraisal process emerged as the strongest predictor (β = .618, p < .001), indicating that employees’ perceptions of appraisal fairness, transparency, and effectiveness strongly influence job outcomes. Performance appraisal practices also significantly predicted Job performance outcomes (β = .181, p = .005). However, performance appraisal feedback outcomes were not statistically significant (β = −.063, p = .175), suggesting that their influence may overlap with other appraisal dimensions included in the model. In conclusion, performance appraisal at KNH improves nurses’ motivation, job satisfaction, and professional development, with performance influenced by demographic factors, feedback quality, and clear appraisal practices. To maximize impact, performance appraisal systems should include structured guidelines, constructive feedback, recognition, and supportive work environments. The study recommends strategic staff placement, supervisor training, integration of feedback with professional development, and continuous monitoring to enhance nurse performance and quality of patient care.