Addressing Nursing Practice Breakdown: An Alternative Approach to Remediation Academic Article uri icon


  • 2019 National Council of State Boards of Nursing The goal of any remediation program is to retain safe nurses in the workforce by increasing knowledge, skill, and competency necessary to prevent future practice breakdown. This article presents a new approach to nursing practice assessment and remediation for nurses sanctioned for a practice violation and includes case studies of two registered nurses (RNs) who entered an agreed order to complete a remediation discipline program as an alternative to traditional discipline. Texas implemented the Knowledge, Skills, Training, Assessment, & Research (KSTAR) Nursing Pilot Program in 2014. It was created with regulatory, practice, and educational collaboration and uses an innovative, individualized approach to remediate nursing practice breakdown (NPB). The program was established as a 2-year pilot study, and outcomes demonstrated that 92% of participants successfully completed the program, with no significant difference in recidivism at 24 months post completion when compared with nurses completing traditional remediation programs. Based on the successful outcomes of this new approach to date, KSTAR is now a permanent option for nurses who require remediation for certain types of practice violations and may serve as a model for the development of individualized remediation programs by other state boards of nursing.

published proceedings

  • Journal of Nursing Regulation

author list (cited authors)

  • Matthews, D. W., Benton, K. K., Moreland, S. C., & Wagner, T.

citation count

  • 2

complete list of authors

  • Matthews, Debra Wise||Benton, Kristin K||Moreland, Susan C||Wagner, Tammy

publication date

  • January 2019