Nursing Peer Review is the preferred method for a review of practice for all levels of nursing licensure. The Chief Nursing Officer (CNO) is responsible for establishing the policies and procedures necessary for peer review of all nursing practice, including APRNs. When peer review proceedings involve a CRNA, at least one nurse on the peer review committee should be a CRNA. The institution may engage the services of a CRNA consultant to assist in the peer review process. Peer review is an important function for both the public and the nursing discipline. Many issues that arise in nurse anesthesia practice require the advanced education and experience of a CRNA to determine whether the individual’s practice is consistent with the standards of care. When the peer review process involves a CRNA, we recommend that at least 3 CRNAs be included to review the facts of the incident to develop an opinion as to whether the applicable standards of care are met. The following sections of the Texas Nursing Practice Act and the Texas BON regulations may be helpful.
According to the Texas BON FAQ regarding Peer Review, Nursing Peer Review law, Section 303.003(c) requires that a Nursing Peer Review Committee that conducts a peer review that involves the practice of professional nursing (including an RN with advanced practice authorization) must:
a. have registered nurses as 2/3 of its members;
b. have only registered nurses as voting members; and
c. where feasible, have at least one nurse with a working familiarity of the area of nursing practice of the nurse being reviewed. If APRN practice is reviewed, preferably have an APRN licensed in the same role and population focus on peer review or advising peer review.
In addition, Rule 217.19(d)(3)(B) and Rule 217.20(h)(2)(B)-(C) exclude from membership or attendance at the Peer Review Committee hearing any person(s) with administrative authority for personnel decisions directly relating to the nurse. A person with administrative authority over the nurse may only appear as a fact witness.
