History of TERCAP® at a National and State Level

TERCAP® at the National Level

The National Council of State Boards of Nursing (NCSBN) developed TERCAP® (Taxonomy of Error, Root Cause Analysis and Practice-responsibility), a national nursing adverse event database, for utilization by boards of nursing for reviewing nursing practice breakdown.   The TERCAP® Project meets the recommendation made in the Institute of Medicine's (IOM) Report Keeping Patients Safe concerning the role of Boards in promoting patient safety. The goal of this project is to learn from incidences of nursing practice breakdown in order to evaluate the multiple factors that may be involved in nursing practice errors. This type of analysis will facilitate the development of strategic interventions to minimize risk factors that may endanger patient safety. Practice breakdown is defined broadly as the disruption or absence of any aspects of good nursing practice.

TERCAP® in Texas

In 2011, the 82nd Texas Legislature passed SB 193 allowing the Board to adopt an error classification system, such as the TERCAP®, for utilization by nursing peer review committees. Pursuant to Section 303.012 of the Texas Occupations Code, the Board utilized TERCAP® as a model in a pilot identifying practice issues normally reviewed by a nursing peer review committee and deemed not reportable to the Board, as a part of a complaint or disciplinary process. The Board developed the Texas TERCAP® Online State-Wide Error Reporting System for participants to enter nurse, patient and system contributions to the error in addition to the types of nursing practice breakdown. Information was de-de-identified and remained confidential. The goal of the pilot was to recognize and highlight factors involved in nursing practice breakdown in order to promote a better understanding of the etiology of nursing practice errors. Identification of contributing factors to practice breakdown and developing methods to mitigate these events should facilitate a proactive approach to promoting patient safety: an approach that the Board believes is important to its mission to protect the public.

The Texas Board of Nursing launched the TERCAP® Pilot Project in August 2012 and finalized it in August 2016.