Hospital Peer Review done, what happens next?

[TxACNP]

I am an NP working in a major hospital. Recently I was emailed by our peer review committee wanting to know answers to questions when I covered for a patient one night. Over the course of the night, I was contacted once abt the patient, and this was not regarding any of the floor nurses concern of pt decompensation or any kind of distress. The nurse gave me no info nor told me the patient was crashing and needed a bedside evaluation. Long story short- the peer review committee graded the case as a "C"which is a "significantly different approach used by most practitioners", however the committee agreed that I was not given sufficient information from the nurse when the patient was acutely ill, to guide my decisions.

I have never been through any kind of peer review, as an RN or an NP. The letter with the committees decision only said the documentation would be placed in my quality file.

Several questions I need help with from any NP colleagues that have been through this or know anything abt the process:

The letter stated no disciplinary action and in don't know if I was the subject or the participant of the investigation, or what prompted the investigation initially.

1) what is grade of "3" and how will it affect me with future Credentialing at other facilities?

2) will this be reported to the BON and NPDA?

3) since no disciplinary action was listed am I to assume there is none?

I appreciate any help! New to the Peer Review aspect of being a provider!

[Psychcns]

-is there a peer review policy you can refer to?

-from what you have written, it sounds like they thought you should have done something differently?

-maybe you could consult with your malpractice carrier

[Corey Narry, MSN, RN, NP]

First, I would talk to a lawyer knowledgeable in Medical Peer Review law in Texas. Each state is different. In some states, Peer Review Committee decisions are supposed to be confidential and not to be used for reporting to regulatory boards or even litigation. In some, they have no such immunity and are reported accordingly (depending on severity).

Also, what kind of committee proceedings were you subjected to? I would have fought tooth and nail to have my name cleared of any wrongdoing especially since you said you were not made aware of the acute change in this patient's condition. How would you have acted in a "significantly different approach used by most practitioners" when you were not aware of the situation you were supposed to act upon?

Peer review investigations can be prompted by a report from an employee of the hospital (nurse, physician, other allied professionals) who feel that a provider did not meet standards in providing care. Typically, it begins with a write-up which is now called by various titles or names depending on where you work.

If you work in a hospital, things such as sentinel events, complaints about you, complications, etc are par for the course. It happens even with best among us. But I surely wouldn't admit to wrongdoing in an accusation that doesn't have merit.