Nursing Peer Review. What is it?

 Serious business, as I noted yesterday. Also, totally new to me.  After doing this job for nearly fourteen years, I freak out a little when something this seemingly major surfaces and I’ve never even heard of it.  So if, like me, this is a new concept to you, read on.  Everybody else, please reserve your judgment.

Under Chapter 303 of the Texas Occupations Code, a nursing peer review committee is established by the governing body of a political subdivision (your school board) to conduct nurse peer reviews.  Generally, a school district with 8 or more nurses must have a peer review committee to conduct nursing peer reviews, but this threshold is also impacted by the number of RNs contracted with or employed.  Schools can also contract with outside entities to provide the services of a nursing peer review committee.  Some education service centers offer nursing peer review, as do hospitals, and even larger school districts will enter into agreements with neighboring districts.

The nurse peer review process itself is a legal mechanism used to evaluate nursing services, the qualification of a nurse (LVN, RN, or APN), the quality of patient care given by nurses, and/or the merits of a complaint about a nurse or nursing care.  The role of a peer review is to determine if a nurse has violated licensure rules and, if so, whether the violations need to be reported to the Board of Nursing.  A peer review committee can issue recommendations regarding any nurse or nursing care complaints, including making recommendations to a school district employer.

There are two types of nursing peer reviews.  The first is incident-based and initiated to review a specific incident or complaint.  The second type is called a “safe harbor” review and is invoked by a nurse prior to accepting an assignment or engaging in conduct that the nurse believes would place patients at risk.

The Occupations Code sets out a fairly comprehensive process for nurse peer review, including specifics of committee membership, notice requirements, confidentiality provisions, and penalties for non-compliance.  From an employment standpoint, it is helpful to keep in mind that nurse peer reviews are licensure and nursing care matters.  Non-nursing issues (e.g., attendance, unprofessional conduct) remain employment matters over which a school district employer still has authority, even during a peer review process.  While schools are not permitted to include, for example, an HR administrator on a peer review committee, the HR administrator could serve as a fact witness for the committee.


 Tomorrow:  The Universe Delivers a Karmic Gift to a Struggling School Law Blog Writer…