Nurses and Peer Review

In 2007, the Texas Legislature amended the Nursing Peer Review rules. The Legislature pointed out that when the Nursing Peer Review rules were enacted in 1987, there was a push for over reporting by multiple entities as a method to promote public safety; however, new studies have demonstrated that over reporting leads to nurses not reporting errors for fear of disciplinary action by the various state nursing boards. The new statute limits what is required for a nurse to be reported to the Texas Board of Nursing.

The Board of Nursing also has Peer Review rules, which set out in detail what is required for nursing peer review. If a nurse receives notification of a pending peer review meeting, the nurse should immediately review the Nurse Practice Act and the Board’s rules to ensure that the facility is following all of the legal requirements for nursing peer review. A nurse should also review the Minor Incident rules as part of preparing for Peer Review.

Safe Harbor Peer Review is different from Incident Based Peer Review. Safe Harbor was enacted to provide protection for nurses who have been asked to engage in conduct, which the nurse believes, would violate the nurse’s duty to a patient. By enacting Safe Harbor, a nurse cannot be retaliated against because of making the request and the nurse may engage in the conduct pending the peer review determination, the nurse is not required to be reported to the Board and the nurse may not be disciplined by the Board for engaging in the conduct pending the peer review. Every nurse should be familiar with the Nurse Practice Act and the Board’s rules pertaining to Safe Harbor Peer Review.