| (a) Advisory committee members.
(1) A hospital shall establish an advisory committee
that meets the requirements of Texas Health and Safety Code Chapter
161, Subchapter D (relating to Medical Committees, Medical Peer Review
Committees, and Compliance Officers).
(2) At least one-third of the advisory committee shall
be registered nurses (RNs) who provide direct patient care at least
50 percent of their work time and at least one of the RNs shall be
from either infection control, quality assurance, or risk management.
(3) For an identifiable mental health services unit
in a hospital licensed under Texas Health and Safety Code Chapter
241 (relating to Hospitals) and 25 TAC Chapter 133 (relating to Hospital
Licensing), the advisory committee may be the advisory committee required
by 25 TAC §133.41 (relating to Hospital Functions and Services).
(b) Advisory committee responsibilities. The advisory
committee shall:
(1) consider input from RNs and licensed vocational
nurses (LVNs) regarding the adequacy of the staffing plan required
by §568.63(g) of this chapter (relating to Nursing Services),
including any concerns reported in accordance with the process required
by §568.63(h) of this chapter;
(2) consider variances between planned and actual numbers
of staff members, as indicated by a report to the advisory committee
by the director of psychiatric nursing (DPN) made in accordance with §568.63(g)(6)
of this chapter;
(3) make recommendations regarding the adequacy of
the staffing plan required by §568.63(g) of this chapter;
(4) evaluate, at least annually, the staffing plan
required by §568.63(g) of this chapter including, in part, evaluating
the aggregated data required by §568.141(d)(2) of this subchapter
(relating to Quality Assessment and Performance Improvement Program)
to determine if such data has a relationship to the adequacy of the
staffing plan; and
(5) document in the minutes of its meetings the actions
required in paragraphs (1) - (4) of this subsection.
(c) Confidentiality of advisory committee records.
As provided by Texas Health and Safety Code §161.032, the records
and proceedings of the advisory committee are confidential and not
subject to disclosure under Texas Government Code Chapter 552 (the
Texas Public Information Act), and not subject to disclosure, discovery,
subpoena, or other means of legal compulsion for their release.
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