NURSING JURISPRUDENCE FINALS ANSWERS AND
QUESTIONS SET A+
✔✔Minor Incidents - ✔✔"conduct that does not indicate that the continuing practice of
nursing by an affected nurse poses a risk of harm to the client or other person."
✔✔Minor Incident Exclusions - ✔✔Conduct that cannot be considered a minor incident:
1. Any error that contributed to a patient's death;
2. Criminal conduct defined in NPA § 301.4535; or
3. A serious violation of the board's Unprofessional Conduct Rule 217.12 involving
intentional or unethical conduct such as fraud, theft, patient abuse or patient
exploitation.
✔✔TOC Chapter 303. Nursing Peer Review - ✔✔Defined by NPA §303.001(5) as the
evaluation of:
nursing services,
the qualifications of a nurse,
the quality of patient care rendered by a nurse,
the merits of a complaint concerning a nurse or nursing care, and
a determination or recommendation regarding a complaint.
✔✔Incident-Based Peer Review - ✔✔Incident-Based, because it relates to an incident
reported after the fact, so it starts with an error or incident
Initiated by a nurse, facility, association, school, agency, or any other setting that utilizes
the services of nurses
✔✔Safe Harbor Peer Review - ✔✔May be initiated by a LVN, RN or APRN prior to
accepting an assignment or engaging in requested conduct that the nurse believes
would place patients at risk of harm, thus potentially causing the nurse to violate his/her
duty to the patient(s).
Invoking safe harbor in accordance with Rule 217.20 protects the nurse from licensure
action by the BON as well as from retaliatory action by the employer.
, Employers of 10 or more licensed nurses must have a Peer Review Committee [TOC §
303.0015 (a) (1) and (2)].
The committee shall give the nurse being reviewed at least minimum due process [TOC
§ 303.002 (e)].
✔✔Due Process Rights - ✔✔A facility conducting incident-based peer review shall:
Have written policies and procedures about peer review
Nurse must receive notice regarding the review, and have an opportunity to respond to
the notice
Nurse may have an attorney, will get feedback after the decision, and have a chance to
respond to the decision
✔✔Minimum Due Process Rights Include - ✔✔Notice must be provided in writing in
person or by certified mail
Notice must Include a description of the event(s) to be evaluated in sufficient detail to
inform the nurse of the incident, circumstances and conduct (error or omission)
The nurse must have the opportunity to:
(i) submit a written statement regarding the event under review;
(ii) call witnesses, question witnesses, and be present when testimony or evidence is
being presented
✔✔Employer Disciplinary Action - ✔✔Employment and licensure issues are separate.
An employer may take disciplinary action before review by the peer review committee is
conducted, as peer review cannot determine issues related to employment.
The role of incident-based peer review is to determine if licensure violations have
occurred and, if so, if the violations require reporting to the board.
✔✔Safe Harbor Peer Review - ✔✔Safe Harbor must be invoked prior to engaging in the
conduct or assignment for which peer review is requested, and may be invoked at any
time during the work period when the initial assignment changes.
Examples of Safe Harbor situations include clinical assignments related to staffing
and/or acuity of patients where the nurse believes patient harm may result [TAC §
217.11(1)(B) and (T)].
Safe Harbor allows nurses to accept assignments, and do the best patient care they are
capable of, without fear of licensure action by the Board if they accidentally commit an
error.
It is important to remember; however, that NPA § 301.352 gives a nurse the right to
refuse to engage in conduct related to patient care if they believe the conduct would
violate the NPA or any BON rule
✔✔Activation of Safe Harbor Peer Review - ✔✔Notify the supervisor making the
assignment in writing that the nurse is invoking Safe Harbor.
QUESTIONS SET A+
✔✔Minor Incidents - ✔✔"conduct that does not indicate that the continuing practice of
nursing by an affected nurse poses a risk of harm to the client or other person."
✔✔Minor Incident Exclusions - ✔✔Conduct that cannot be considered a minor incident:
1. Any error that contributed to a patient's death;
2. Criminal conduct defined in NPA § 301.4535; or
3. A serious violation of the board's Unprofessional Conduct Rule 217.12 involving
intentional or unethical conduct such as fraud, theft, patient abuse or patient
exploitation.
✔✔TOC Chapter 303. Nursing Peer Review - ✔✔Defined by NPA §303.001(5) as the
evaluation of:
nursing services,
the qualifications of a nurse,
the quality of patient care rendered by a nurse,
the merits of a complaint concerning a nurse or nursing care, and
a determination or recommendation regarding a complaint.
✔✔Incident-Based Peer Review - ✔✔Incident-Based, because it relates to an incident
reported after the fact, so it starts with an error or incident
Initiated by a nurse, facility, association, school, agency, or any other setting that utilizes
the services of nurses
✔✔Safe Harbor Peer Review - ✔✔May be initiated by a LVN, RN or APRN prior to
accepting an assignment or engaging in requested conduct that the nurse believes
would place patients at risk of harm, thus potentially causing the nurse to violate his/her
duty to the patient(s).
Invoking safe harbor in accordance with Rule 217.20 protects the nurse from licensure
action by the BON as well as from retaliatory action by the employer.
, Employers of 10 or more licensed nurses must have a Peer Review Committee [TOC §
303.0015 (a) (1) and (2)].
The committee shall give the nurse being reviewed at least minimum due process [TOC
§ 303.002 (e)].
✔✔Due Process Rights - ✔✔A facility conducting incident-based peer review shall:
Have written policies and procedures about peer review
Nurse must receive notice regarding the review, and have an opportunity to respond to
the notice
Nurse may have an attorney, will get feedback after the decision, and have a chance to
respond to the decision
✔✔Minimum Due Process Rights Include - ✔✔Notice must be provided in writing in
person or by certified mail
Notice must Include a description of the event(s) to be evaluated in sufficient detail to
inform the nurse of the incident, circumstances and conduct (error or omission)
The nurse must have the opportunity to:
(i) submit a written statement regarding the event under review;
(ii) call witnesses, question witnesses, and be present when testimony or evidence is
being presented
✔✔Employer Disciplinary Action - ✔✔Employment and licensure issues are separate.
An employer may take disciplinary action before review by the peer review committee is
conducted, as peer review cannot determine issues related to employment.
The role of incident-based peer review is to determine if licensure violations have
occurred and, if so, if the violations require reporting to the board.
✔✔Safe Harbor Peer Review - ✔✔Safe Harbor must be invoked prior to engaging in the
conduct or assignment for which peer review is requested, and may be invoked at any
time during the work period when the initial assignment changes.
Examples of Safe Harbor situations include clinical assignments related to staffing
and/or acuity of patients where the nurse believes patient harm may result [TAC §
217.11(1)(B) and (T)].
Safe Harbor allows nurses to accept assignments, and do the best patient care they are
capable of, without fear of licensure action by the Board if they accidentally commit an
error.
It is important to remember; however, that NPA § 301.352 gives a nurse the right to
refuse to engage in conduct related to patient care if they believe the conduct would
violate the NPA or any BON rule
✔✔Activation of Safe Harbor Peer Review - ✔✔Notify the supervisor making the
assignment in writing that the nurse is invoking Safe Harbor.
