Texas Board of Nursing to Offer New Resource for Incident-Based Nursing Peer Review

TERCAP (Taxonomy of Error, Root Cause Analysis and Practice-Responsibility) is a national nursing adverse event database created by the National Council of State Boards of Nursing (NCSBN) designed to collect nursing practice breakdown data from boards of nursing.

The TERCAP intake instrument provides a multifocal approach to investigating nursing practice breakdown by providing a template to categorize the type of nursing practice breakdown as well as identifying individual nurse, patient, healthcare team and system contributing factors surrounding the event. This instrument is used by boards of nursing to categorize and collect data on events reported to them.

In 2011, the 82nd Legislature passed SB 193 allowing the Texas Board of Nursing (Board or BON) to adopt a standardized error classification system for utilization by nursing peer review committees. At this time, the BON implemented a pilot project that utilized the national instrument and its structure for the review of nursing practice breakdown by nursing peer review committees for minor incidents.

The pilot project took place from Sept. 1, 2012, to Aug. 21, 2016. Included in the project were a total of 52 hospital system’s nursing peer review committees who voluntarily entered a total of 318 non-Board reportable events in the database. More information about TERCAP, including a final summary of the Texas TERCAP pilot, can be found on the Board’s website.

Since completion of the TERCAP Pilot Project in 2016, the Board has worked diligently to capitalize on important findings of the pilot. Among these findings is that participating nursing peer review committees provided very favorable responses to the TERCAP instrument. Another important finding was that some nursing peer review committees were not familiar with the Board’s rules related to nursing peer review; in particular, what events constituted a minor practice breakdown incident versus an event that required a report to the BON. Consequently, using TERCAP as a template, the Board has developed the Nursing Peer Review Evaluation of Practice Breakdown (N-PREP). N-PREP is a voluntary resource tool that guides nursing peer review committees in their evaluation of nursing practice breakdown, converging in the end to a decision tree designed to aid the committee in its final determination for remediation or reporting to the Board. The Board plans to provide this resource to all nursing peer review committees across the state, and, as such, staff will be conducting educational offerings for nursing peer review chairpersons in July and August as well as developing an online orientation module to be available on the Board’s website later this fall.

N-PREP training for nursing peer review chairs will be held in person:

• July 12 at the University of Texas Commons Conference Center in Austin
• August 23 at the University of Texas Health Science Center at Houston Cizik School of Nursing

Please visit the Texas Board of Nursing website under the UPDATES, NEWS AND NOTICES section of the main page for N-PREP Training for Nursing Peer Review Committee Chairs registration details.