Texas Peer Assistance Program for Nurses
The 2025 Matrix: 7 Key Updates
Combining the newest evidence-based recommendations and person-centered principles for sustainable recovery.
Brittney Majefski, MSN, RN, PMH-BC
Program Director, Texas Peer Assistance Program for Nurses
IT IS LIKELY NO SURPRISE to you that healthcare professional monitoring programs are not easy. Being that they are responsible for aiding in the recovery of individuals working in safety sensitive professions, the goal is not to be “easy” but to be effective in sustainable recovery. Periodically reviewing the evidence in relation to positive outcomes and patient centered practice allows monitoring programs to guide positive recovery outcomes. Over the last year, the Texas Peer Assistance Program for Nurses (TPAPN) has been working toward incorporating the latest evidence thus continuing its commitment to patient-centered approaches for participants .
TPAPN has worked collaboratively with our regulatory bodies and experts in the field to review the latest research and listen to feedback from behavioral health professionals and stakeholders to incorporate updates to the program. These updates align with both supporting nurses through recovery and ensuring a strong level of accountability. In doing this exercise, TPAPN has established person-centered improvements to what we call our Matrix.
The Matrix was created in 2019 after The Sunset Commission indicated a need for a more consistent and flexible set of treatment recommendations and requirements for nurses in TPAPN. Since 2019, TPAPN has used the Matix to give both structure and individualization to its monitoring plans. In 2025, after leaning into our goal of offering more individualized therapeutic monitoring programs, we made the following updates.
TPAPN has worked collaboratively with our regulatory bodies and experts in the field to review the latest research and listen to feedback from behavioral health professionals and stakeholders to incorporate updates to the program. These updates align with both supporting nurses through recovery and ensuring a strong level of accountability.
MATRIX 2025 UPDATES
SEVEN KEY CHANGES
1. Reviewed and updated length of time required in monitoring to be more specifically related to diagnosis, remission classification and remission time frame (if applicable).
2. Decreased standard length of time in program from 3-5 years to 1-5 years depending upon various factors.
3. Decreased toxicology testing frequency and have more individualized toxicology requirements.
4. Updated work-related restrictions for APRNs/CRNAs including potentially decreasing time away from anesthesia practice or controlled substance prescription authority.
5. Added additional earned advocacy initiatives for adherence to monitoring. (Tapering off of certain restrictions as the participant goes through recovery and monitoring successfully).
6. Increased options for individualized support recovery activities.
7. Expanded our mental health track for nurses that do not have a diagnosed substance use disorder and have more options for those that may be needing or wanting support for their mental health as they continue to practice. Our Matrix now has expanded from one mental health track to three variations depending on what the nurses’ individualized needs may be.
*Matrix track placement is dependent on a variety of factors from diagnosis, remission status, work incidents, recovery needs, referral reason/source, individual needs, etc.
Since beginning in 1987, TPAPN , like most everything in healthcare, continues to evolve. Being more person-centered while still ensuring we have structure and fidelity will continue to be top of mind. The rate of nurses struggling with mental health conditions including substance use disorder is not declining. As healthcare professionals, nurses must have a way to get assistance through both support and accountability. TPAPN will continue to work with our stakeholders, including those with lived experience, and incorporate best practices into its monitoring program while focusing on person-centered interventions to encourage successful recovery.
If you are interested in learning more about TPAPN or volunteering as a Peer Support Partner, check out our website at TPAPN.ORG and reach out today! TN
NURSE SUPPORT RESOURCES
Phone: 800.288.5528 or 512.467.2620
Email: tpapn@texasnurses.org
Website : https://www.texasnurses.org/mpage/TPAPN
LinkedIn: https://www.linkedin.com/company/texas-peer-assistance-program-for-nurses-tpapn
