nursing peer review

Roles of nursing peer review

1. Determine accountability ( in incident-based peer review) 2. Advise as to a nurse's duty (in the case of safe harbor) 3. Evaluate a nurse's ability to practice competently (in minor incident peer reivew) 4. Identify system errors that may have contributed to the incident

Incident-based Nursing Peer Review primary functions

1. Evaluate an individual nurse's practice, conduct or an event, assigning accountability. 2. Identify factors beyond the nurse's control 3. Report pertinent findings to the BON and make recommendations concerning the nurse.

legally required?

1. Every facility that employs 10 or more nurses must have a nursing peer review committee that has written policies. 2. Nurses must be afforded due process (meaning proper notice, the right to have an attorney present, etc.). 3. Reports to the BON must contain certain facts.

There are three types of peer review discussed in the Nurse Practice Act

1. Incident based peer review 2. Minor incident peer review 3. Safe harbor peer review

Nursing peer review includes the evaluation of

1. Nursing services, 2. The qualifications of the nurse 3. Quality of patient care rendered by the nurse 4. The merits of a complaint concerning a nurse or nursing care 5. A recommendation regarding any complaints against the nurse

Rights of the nurse being reviewed

1. To be reviewed by a committee of peers. 2. Receive minimum due process as defined by Rule 217.19 (d) 3. Be held accountable for a deficiency in care only to the extent that it was the result a deficiency in the nurse's judgment, knowledge, training or skill and not to factors beyond the nurse's control.

The supervisor or manager of the nurse is required to report the nurse to the peer review committee if

5 or more minor incidents occur in a 12 month period

Safe Harbor Peer review does protect the nurse from

BON discipline and employer discipline during the time determination is being made regarding the conduct It does not protect the nurse from potential lawsuits that patients may bring It does not protect the nurse from being fired later by the facility

professionals that utilize peer review

Nurses, physicians and other

Starting in ______ all new graduates will be required to pass an exam that covers the Nurse Practice Act and the Rules and Regulations of the BON, with a 75%.

September 2008,

T/F The BON believes that protection of the public is not enhanced by reporting every minor incident that may be a violation of the Nurse Practice Act

T

The Texas Nurse Practice Act (NPA) is a part of the

Texas Occupations Code

The nurse has the right in a safe harbor

To not have on the committee anyone with administrative authority for personnel decisions To appear before the committee (with an advocate) To ask questions and respond to questions of the committee To make a verbal or written statement to explain why he/she believes the requested conduct would have violated the nurse's duty to a patient.

There are 4 parts to each Unit:

Unit Objectives Graded Assignments Learning Activities Resources

The Nurse Practice Act states that it is the duty of a nurse to report:

Unprofessional conduct by a nurse you may observe Failure of a nurse to adequately care for a patient Failure of a nurse to conform to the minimum standards of acceptable nursing practice Impairment or likely impairment of a nurse's practice by chemical dependency.

Because the nursing peer review committee must report any significant findings to the BON, the duty of a nurse to report the conduct of another nurse is met by reporting to

a nursing peer review committee.

Nursing Jurisprudence Exam

all new graduates will be required to pass an exam that covers the Nurse Practice Act and the Rules and Regulations of the BON, with a 75%.

Invoking Safe Harbor protects the nurse from

board action while a determination is made regarding the conduct in question.

Rule 217.19

incident -based peer review should be a fact-finding process and study of the events done in a climate of collegial problem-solving

to invoke Safe Harbor the nurse must

make a good faith request.

The committee is advisory

meaning that the nurse administrator can overrule if he/she believes in good faith that the committee's findings are incorrect. This is risky, however, to assume that his/her judgment is better than the committee's. This decision can be reported to the BON by the peer review committee

Chapter 301 is dedicated to

nurse practice, npa is referred to as CH 301

Nursing peer review allows a committee composed of one's peers to determine what

nurse's accountability in the given situation

Nursing peer review allows a committee composed of one's what:

peers—other nurses

safe harbor peer review gives the nurse a right to

request

a minor incident is one in which

state that the nurse's continuing to practice does not pose a risk of harm to a client or other person.

safe harbor gives the nurse a right to reques

that a peer review committee evaluate the situation and determine what is the nurse's duty in this situation

"Good faith" means that the nurse believes

that the requested conduct violates a nurse's duty to a patient and that the belief is one a reasonable nurse could hold.

incident -based peer review should be a fact-finding process and study of the events done in a climate of collegial problem-solving according to

the Texas Nurse's Association attorney John Willman

safe harbor peer review protects the nurse from

the employer making the request and any discipline from the employer (such as termination)

what states that it is the duty of a nurse to report

the nurse practice act

When a negative event occurs, an investigation will be done to determine what:

why, and what factors could have prevented it

requirements of safe harbor making

It MUST be in writing It MUST be either on the form provided by the BON or contain the same information. BON process must be followed.

The nurse MUST make the request for Safe Harbor when

AT THE TIME requested to engage in conduct that the nurse believes violates the duty to the patient

safe harbor peer review protects the nurse from action by the:

BON regarding this situation, pending their decision