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TITLE 22EXAMINING BOARDS
PART 11TEXAS BOARD OF NURSING
CHAPTER 217LICENSURE, PEER ASSISTANCE AND PRACTICE
RULE §217.20Safe Harbor Nursing Peer Review and Whistleblower Protections

    (C) If the CNO or nurse administrator believes the nursing peer review was conducted in bad faith, she/he has a duty to report the nurses involved under TOC §301.402 (NPA) and §217.11(1)(K) of this title.

    (D) This section does not affect the protections under TOC §303.005(c)(1) and §301.352 relating to a nurse's protection from disciplinary action or discrimination for making a request for safe harbor nursing peer review.

(k) Use of Informal WorkGroup In Safe Harbor Nursing Peer Review. A facility may choose to initiate an informal review process utilizing a workgroup of the nursing peer review committee provided that the final determination of the nurse's duty complies with the time lines set out in this rule and there are written policies for the informal workgroup that require:

  (1) the nurse to:

    (A) be informed how the informal workgroup will function and that the nurse does not waive any right to nursing peer review by accepting or rejecting the use of an informal workgroup; and

    (B) consent, in writing, to the use of an informal workgroup;

  (2) the informal workgroup to comply with the membership and voting requirements of subsection (h) of this section;

  (3) the nurse to be provided the opportunity to meet with the informal workgroup;

  (4) the nurse to have the right to reject any decision of the informal workgroup and have the entire committee determine if the requested conduct or assignment violates the nurse's duty to the patient(s), in which event members of the informal workgroup shall not participate in that determination;

  (5) ratification by the safe harbor nursing peer review committee chairperson of any decision made by the informal workgroup. If the chairperson disagrees with a determination of the informal workgroup, the chairperson shall convene the full nursing peer review committee to review the conduct in question; and

  (6) the nursing peer review chairperson communicate any decision of the informal workgroup to the CNO or nurse administrator.

(l) Reporting Conduct of other Practitioners or Entities; Whistleblower Protections.

  (1) This subsection does not expand the authority of any safe harbor nursing peer review committee or the Board to make determinations outside the practice of nursing.

  (2) In a written, signed report to the appropriate licensing Board or accrediting body, and in accordance with TOC §301.4025, a nurse may report a licensed health care practitioner, agency, or facility that the nurse has reasonable cause to believe has exposed a patient to substantial risk of harm as a result of failing to provide patient care that conforms to:

    (A) minimum standards of acceptable and prevailing professional practice, for a report made regarding a practitioner; or

    (B) statutory, regulatory, or accreditation standards, for a report made regarding an agency or facility.

  (3) A nurse may report to the nurse's employer or another entity at which the nurse is authorized to practice any situation that the nurse has reasonable cause to believe exposes a patient to substantial risk of harm as a result of a failure to provide patient care that conforms to minimum standards of acceptable and prevailing professional practice or to statutory, regulatory, or accreditation standards. For purposes of this subsection, an employer or entity includes an employee or agent of the employer or entity.

  (4) A person may not suspend or terminate the employment of, or otherwise discipline, retaliate, or discriminate against, a person who reports, in good faith, under this section or advises a nurse of the nurse's rights and obligations under this section. A violation of this subsection is subject to TOC §301.413 that provides a nurse the right to file civil suit to recover damages. The nurse may also file a complaint with the regulatory agency that licenses or regulates the nurse's practice setting. The BON does not have regulatory authority over practice settings or civil liability.


Source Note: The provisions of this §217.20 adopted to be effective May 11, 2008, 33 TexReg 3633; amended to be effective July 29, 2008, 33 TexReg 5930; amended to be effective January 9, 2012, 37 TexReg 62; amended to be effective April 26, 2018, 43 TexReg 2419; amended to be effective October 22, 2019, 44 TexReg 6031

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