Nursing Peer Review Evaluation of Practice-breakdown (N-PREP)

The Taxonomy of Error Root Cause Analysis of Practice-responsibility (TERCAP®) was developed by National Council of State Boards of Nursing to promote the identification and analysis of factors that contribute to practice breakdown. In 2012, the Texas Board of Nursing (Board or BON) implemented a pilot program that allowed nursing peer review committees to use a modified version of the TERCAP® intake instrument. Since the cessation of the TERCAP Pilot Program in 2016, the Board has worked diligently to capitalize on important findings of the pilot.

Utilizing the findings from the TERCAP Pilot Program, the Board has developed a resource that may be utilized by nursing peer review committees for a comprehensive evaluation of nursing practice breakdown. Known as N-PREP (Nursing Peer Review Evaluation of Practice-breakdown), this resource was created with the overall intent to support an organization’s nursing peer review processes. N-PREP’s template is broad enough to provide both guidance and flexibility to the nursing peer review process so that all of the hundreds of nursing peer review committees throughout the state may successfully incorporate the resource into their own organizational structure. N-PREP is a means to support the committee’s analysis of incidents to determine if the nurse’s conduct is: required to be reported to the Board, constitutes a minor incident that is not required to be reported to the Board and may be remediated at the facility level, or does not constitute a deficit in practice.

This resource may be used voluntarily by healthcare organizations to promote an objective, just approach to evaluating nursing practice breakdown in compliance with regulatory guidelines. If an organization decides to utilize N-PREP, it is highly recommended that those involved in the nursing peer review process complete the training module, which may be accessed below, before implementing N-PREP. The training module is an overview of the resource with an explanation of the intent of each section and its role in the overall review of nursing practice breakdown.