TX NJE - Texas Nursing Jurisprudence Nursing Peer Review Process Questions and Answers — Questions and Answers
Question 1: A nurse is notified that their practice is being evaluated by an incident-based nursing peer review committee. According to the Texas Administrative Code, which of the following represents a fundamental due process right afforded to the nurse during this process?
- The right to have legal counsel paid for by the facility.
- The right to receive written notice of the committee's findings no more than 5 calendar days after the review is complete.
- The right to be present when testimony is being presented and to question witnesses. (Correct answer)
- The right to have the peer review proceedings paused indefinitely upon the nurse's request.
Correct answer: The right to be present when testimony is being presented and to question witnesses.
Texas Administrative Code Rule 217.19(d) outlines the minimum due process rights for a nurse in an incident-based peer review. These rights include being given written notice, a description of the event, and the opportunity to be present, call witnesses, and question witnesses during the proceeding.
Question 2: A hospital that regularly employs 30 nurses, including 20 RNs and 10 LVNs, establishes a nursing peer review committee. According to the Texas Occupations Code, what is the primary purpose of this committee?
- To determine the nurse's employment status and issue disciplinary action.
- To evaluate nursing services and determine if a nurse's conduct requires reporting to the Board of Nursing. (Correct answer)
- To mediate workplace disputes between nurses and other healthcare professionals.
- To approve and oversee continuing nursing education (CNE) for the facility's staff.
Correct answer: To evaluate nursing services and determine if a nurse's conduct requires reporting to the Board of Nursing.
The Texas Occupations Code §303.001(5) defines peer review as the evaluation of nursing services, the qualifications of a nurse, the quality of patient care, and the merits of a complaint, ultimately to determine or recommend whether a report to the Board of Nursing is warranted. The committee does not make employment decisions, though the employer may use its findings to inform their own decisions.
Question 3: A nurse believes an assignment from a supervisor would violate their duty to a patient and could potentially violate the Nursing Practice Act. To be protected from employer retaliation, the nurse invokes Safe Harbor. When must the nurse invoke this protection?
- Within 24 hours after completing the assignment.
- At any point during the nurse's employment at the facility.
- After discussing the concern with the patient's family.
- Prior to engaging in the conduct or assignment for which peer review is requested. (Correct answer)
Correct answer: Prior to engaging in the conduct or assignment for which peer review is requested.
According to BON Rule 217.20, Safe Harbor must be invoked *prior* to engaging in the conduct or assignment. It can be invoked when the assignment is made or at any time during the work period if the initial assignment changes in a way that the nurse believes could cause patient harm.
Question 4: An incident-based peer review committee is convened to review the practice of a Registered Nurse (RN). Which of the following is a specific requirement for the composition of this committee according to the Nursing Practice Act?
- The committee must be chaired by a physician.
- At least two-thirds of the members must be Registered Nurses, and only RNs may vote. (Correct answer)
- The majority of members must be from outside the employing facility to ensure impartiality.
- Exactly half the members must be LVNs and half must be RNs.
Correct answer: At least two-thirds of the members must be Registered Nurses, and only RNs may vote.
Texas Occupations Code §303.003(c) specifies that a peer review committee reviewing the practice of professional nursing must have registered nurses as two-thirds of its members, and only registered nurses are permitted to be voting members.
Question 5: Which of the following situations would obligate a home health agency that regularly employs 12 nurses (7 RNs, 5 LVNs) to conduct an incident-based nursing peer review?
- A nurse requests a schedule change due to personal reasons.
- A physician disagrees with a nurse's documented assessment.
- A nurse commits five minor incidents within a 12-month period. (Correct answer)
- A patient provides a positive satisfaction survey about a nurse.
Correct answer: A nurse commits five minor incidents within a 12-month period.
Texas Administrative Code Rule 217.16(e) specifies that in practice settings with nursing peer review, a nurse must be reported to the peer review committee if they commit five minor incidents within a 12-month period, as this may indicate a pattern of practice that poses a risk of harm.
Question 6: A nurse serves on a nursing peer review committee and participates in the evaluation of a colleague's practice. The committee proceedings are conducted in good faith. What protection is this nurse afforded under the Texas Occupations Code?
- Guaranteed promotion within the facility for their service.
- Complete anonymity, where their identity is never revealed to the nurse being reviewed.
- Immunity from civil liability for any act or recommendation made without malice during the peer review process. (Correct answer)
- The authority to independently report the nurse to the BON, regardless of the committee's findings.
Correct answer: Immunity from civil liability for any act or recommendation made without malice during the peer review process.
Texas Occupations Code §303.006 grants immunity from civil liability to members of a nursing peer review committee for any act, statement, determination, or recommendation made in the course of peer review, provided it is done in good faith and without malice.
TX NJE - Texas Nursing Jurisprudence Nursing Peer Review Process Questions and Answers
A nurse is notified that their practice is being evaluated by an incident-based nursing peer review committee.
According to the Texas Administrative Code, which of the following represents a fundamental due process right afforded to the nurse during this process?