What is Nurse Peer Review?
The Nurse Peer Review (NPR) Law in Texas is a law that is available to nurses to protect their license. The Texas Occupational Code Nurse Peer Review Law (TOC Chapter 303) can be and should be used by nurses under the right circumstances. There are 2 components to this law-one is incident based peer review while the second part is related to safe harbor peer review. To help provide a clearer understanding, the Texas Board of Nursing has developed rules which can be found in the Texas Administrative Code (Chapter 217, Rule 217.19 and Rule 217.20). These rules interpret the meaning of the law making it easier to understand. The NPR Law also uses these rules to address whistle blower protection which is designed to prevent employers from retaliating against a nurse’s license. Peer Review can be used when the nurse makes a good faith request for safe harbor, refuses to engage in an act or omission related to patient care that would constitute a violation to the Nursing practice Act and/or Board rules, or make a lawful report of unsafe practitioners or unsafe patient care practices. The Nurse Peer Review Law applies to registered nurses, nurses with advanced practice authorization, and licensed vocational nurses.
Peer review as the name implies is a review by your peers using the committee format. It is not a tool to be used by administration/leadership to sanction or support actions they wish to take against a nurse. The purpose of the Nurse Peer Review Law is to evaluate nursing services, qualifications of the nurse, and quality of care given by the nurse as well as consideration of recommendations regarding the complaint or situation. Facilities should have a written plan and assure that nurses are aware of the plan. The peer review committee analyzes the information, focuses on the relevant facts and by definition recommendations made by peers. Nurses in administrative and supervisory position are not voting member of the Nurse Peer Review committee.
Each nurse is encouraged to know the plan where they work before they find themselves in a position of needing, but not knowing their rights as spelled out by the Texas Nursing Practice Act and Board rules. You are not expected to know the details of the plan but know how to access it and have a general idea of its content.