reglab/statecodes huggingface dataset:
Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 11 - TEXAS BOARD OF NURSING › Chapter 219 - ADVANCED PRACTICE NURSE EDUCATION › Section 219.1 - General Requirements and Purpose

Current through Reg. 49, No. 28; July 12, 2024
(a)
				General Requirements. Advanced practice registered nursing education programs
				in the State of Texas shall be approved by the Board until the program is
				accredited or approved by a national advanced practice registered nursing
				education accrediting body recognized by the Board.
(1) An educational institution located in
				Texas may apply for Board approval for advanced practice registered nursing
				education programs that prepare either nurse practitioners or clinical nurse
				specialists. Only that portion of the program of study that qualifies
				registered nurses for licensure in an advanced practice registered nurse role
				and population focus recognized by the Board is eligible for approval. Board
				approval shall be limited to only those programs seeking initial approval that
				do not otherwise hold national accreditation or approval from a national
				nursing education accrediting body for master's or doctoral level nursing
				education.
(2) To be eligible to
				apply for Board approval, the new advanced practice registered nursing
				education program must be at or beyond the master's level of nursing
				education.
Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 11 - TEXAS BOARD OF NURSING › Chapter 219 - ADVANCED PRACTICE NURSE EDUCATION › Section 219.3 - Program Development, Closure, and Transfer of Administrative Control

Current through Reg. 49, No. 28; July 12, 2024
(a) New Programs.
(1) Proposal to develop an advanced practice
				registered nursing education program.
(A) A
				college or university regionally accredited by an agency recognized by the
				THECB is eligible to submit a proposal to develop a new advanced practice
				registered nursing education program.
(B) The process to establish a new advanced
				practice registered nursing education program shall be initiated by a letter of
				intent from the educational institution to the Board office. The timeline for
				proposal development is one (1) year from the date of receipt of the initial
				proposal draft in the Board office .
(C) The individual writing the proposal for a
				new advanced practice registered nursing education program shall be the
				proposed dean/director and shall meet the qualifications for the program
				dean/director, as specified in §
											219.6
				of this chapter (relating to Administration and Organization).
(D) Sufficient nursing faculty with
				appropriate expertise shall be in place for development of the curriculum
				component of the program.
(E) The
				proposal shall include information outlined in Board Education Guidelines
				3.1.1.e. Proposal to Establish a New Advanced Practice Registered Nursing
				Education Program .
(F) After the
				proposal is submitted and determined to be complete , a preliminary survey
				visit shall be conducted by Board staff prior to presentation to the
				Board.
(G) The proposal shall be
				considered by the Board following a public hearing at a regularly scheduled
				meeting of the Board. The Board may approve the proposal and grant initial
				approval to the new program, may defer action on the proposal, or may deny
				further consideration of the proposal.
(H) The program may not enroll students until
				the Board approves the proposal and grants initial approval.
(I) Prior to presentation of the proposal to
				the Board, evidence of approval from the appropriate regulatory agencies shall
				be provided.
(J) When the proposal
				is submitted, an initial approval fee shall be assessed per §
											223.1 of this
				title (related to Fees) .
(K) A
				proposal without action for one (1) calendar year shall be considered
				withdrawn. A new proposal application and fee, as set forth in §
											223.1 of this
				title (relating to Fees), will be required to begin the new proposal process
				again.
(L) If the Board denies a
				proposal, the educational institution must wait a minimum of twelve (12)
				calendar months from the date of the denial before submitting a new proposal to
				establish an advanced practice registered nursing education program.
Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 11 - TEXAS BOARD OF NURSING › Chapter 219 - ADVANCED PRACTICE NURSE EDUCATION › Section 219.4 - Approval

Current through Reg. 49, No. 28; July 12, 2024
(a) The progressive designation of approval
				status is not implied by the order of the following listing. Approval status is
				based upon each program's performance and demonstrated compliance to the
				Board's requirements and responses to the Board's recommendations. Change from
				one status to another is based on survey visits or other factors listed under
				this subsection. Types of approval include:
(1) Initial Approval.
(A) Initial approval is written authorization
				by the Board for a new program to enroll students, is granted if the program
				meets the requirements and addresses the recommendations issued by the Board,
				and begins with the date of the first student enrollment.
(B) The number of students to be enrolled
				while the program is on initial approval is determined by the Board, and the
				requirements are included in the Board Order.
Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 11 - TEXAS BOARD OF NURSING › Chapter 219 - ADVANCED PRACTICE NURSE EDUCATION › Section 219.5 - Mission/Philosophy and Objectives/Outcomes

Current through Reg. 49, No. 28; July 12, 2024
(a) The
				philosophy/mission and objectives/outcomes of the advanced practice registered
				nursing education program shall be consistent with the philosophy/mission of
				the governing institution .
(b) The
				philosophy/mission and objectives/outcomes shall be consistent with:
(1) The philosophy/mission of the governing
				institution;
(2) The scope of
				practice of the advanced practice registered nurse role and population
				focus;
(3) The targeted population
				or setting for delivery of advanced practice registered nursing care;
				and
(4) Professional, educational,
				and ethical standards of nursing.
Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 11 - TEXAS BOARD OF NURSING › Chapter 219 - ADVANCED PRACTICE NURSE EDUCATION › Section 219.6 - Administration and Organization

Current through Reg. 49, No. 28; July 12, 2024
(a) The
				advanced practice registered nursing education program shall operate within or
				be affiliated with a college or university authorized to award graduate
				degrees.
(b) The governing
				institution shall be regionally accredited by an agency recognized by the Texas
				Higher Education Coordinating Board.
(c) There shall be an organizational chart
				that demonstrates the relationship of the advanced practice registered nursing
				education program to the governing institution and indicates lines of
				responsibility and authority.
(d)
				In colleges and universities, the advanced practice registered nursing
				education program shall have comparable status with other academic units within
				the governing institution in such areas as budgetary authority, rank,
				promotion, tenure, leave, benefits, and professional development.
(e) Salaries shall be adequate to recruit,
				employ, and retain sufficient qualified nursing faculty members with graduate
				preparation and expertise necessary for students to meet program
				goals.
(f) The governing
				institution shall provide financial support and resources needed to operate an
				advanced practice registered nursing education program that meets the legal and
				educational requirements of the Board and fosters achievement of program goals.
				The financial resources shall support adequate educational facilities,
				equipment, and qualified administrative and instructional personnel.
(g) Each advanced practice registered nursing
				education program shall be administered by a qualified individual who is
				accountable for the planning, implementation, and evaluation of the advanced
				practice registered nursing education program. The dean or director shall:
(1) hold a current, valid, unencumbered
				license or privilege to practice as a registered nurse in the State of
				Texas;
(2) hold a minimum of a
				master's degree in nursing, doctoral-level preferred, or the equivalent thereof
				as determined by the Board;
(3) be
				authorized to practice as an advanced practice registered nurse in a role and
				population focus appropriate to the type of program;
(4) have a minimum of two (2) years teaching
				experience in a program appropriately related to the type of program being
				administered; and
(5) have
				demonstrated knowledge, skills, and abilities in administration within graduate
				level advanced practice registered nursing education programs.
Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 11 - TEXAS BOARD OF NURSING › Chapter 219 - ADVANCED PRACTICE NURSE EDUCATION › Section 219.7 - Faculty Qualifications and Faculty Organization

Current through Reg. 49, No. 28; July 12, 2024
(a) There shall be written personnel policies
				for nursing faculty that are in keeping with accepted education standards and
				are consistent with those of the governing institution to the extent possible.
				Variations of these policies may be necessary because of the nature of the
				curriculum for which the faculty must have authority and responsibility.
(1) Policies concerning workload for faculty
				and the director shall be in writing.
(2) Sufficient time shall be provided faculty
				to accomplish those activities related to the teaching-learning process as well
				as meet other responsibilities/expectations such as scholarly activities,
				practice, and research.
Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 11 - TEXAS BOARD OF NURSING › Chapter 219 - ADVANCED PRACTICE NURSE EDUCATION › Section 219.8 - Students

Current through Reg. 49, No. 28; July 12, 2024
(a) Students should have a mechanism for
				input into the development of academic policies and procedures, curriculum
				planning, and evaluation of teaching effectiveness.
(b) The number of students admitted to the
				program shall be determined by the number of qualified faculty, adequate
				educational facilities and resources, and the availability of appropriate
				clinical learning experiences for students.
(c) Written policies regarding student
				admission and progression shall be developed and implemented in accordance with
				the requirements that the governing institution must meet to maintain
				accreditation. Student policies that differ from those of the governing
				institution shall be in writing and shall be made available to faculty and
				students.
(d) Students shall hold a
				current, valid license or privilege to practice as a registered nurse in the
				state(s) in which they participate in any clinical learning experiences,
				including, but not limited to, laboratory or observational experiences
				involving patient contact or having the potential to involve patient contact,
				including contact via telehealth.
(e) There shall be written policies for
				student grievance, health, safety, and welfare.
(f) Students shall have the opportunity to
				evaluate faculty, courses, and learning resources and these evaluations shall
				be documented.
Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 11 - TEXAS BOARD OF NURSING › Chapter 219 - ADVANCED PRACTICE NURSE EDUCATION › Section 219.9 - Program of Study

Current through Reg. 49, No. 28; July 12, 2024
(a) The program of
				study shall be:
(1) At least the equivalent
				of one (1) academic year;
(2)
				Planned, implemented, and evaluated by the faculty;
(3) Based on the philosophy/mission and
				objectives/outcomes;
(4) Organized
				logically and sequenced appropriately;
(5) Based on educational principles
				acceptable to the Board; and
(6) At
				or beyond the master's degree level.
Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 11 - TEXAS BOARD OF NURSING › Chapter 219 - ADVANCED PRACTICE NURSE EDUCATION › Section 219.10 - Management of Clinical Learning Experiences and Resources

Current through Reg. 49, No. 28; July 12, 2024
(a) Faculty shall be responsible and
				accountable for managing clinical learning experiences of students.
(b) Faculty shall develop criteria for the
				selection of affiliating agencies/clinical facilities or clinical practice
				settings that address safety and the need for students to achieve the program
				outcomes (goals) through advanced practice registered nursing.
(c) Faculty shall select and evaluate
				affiliating agencies/clinical facilities or clinical practice settings that
				provide students with opportunities to achieve the goals of the
				program.
(d) Written agreements
				between the program and the affiliating agencies shall specify the
				responsibilities of the program to the agency and the responsibilities of the
				agency to the program. Such agreements shall be developed jointly with the
				affiliating agency, reviewed periodically according to the policies of the
				program and the affiliating agency, and include provisions for adequate notice
				of termination.
(e) When clinical
				preceptorships are used in an advanced practice registered nursing education
				program, the following conditions shall be met:
(1) Written agreements between the program,
				clinical preceptor and the affiliating agency/clinical facility, when
				applicable, shall delineate the functions and responsibilities of the parties
				involved.
(2) Criteria for
				selecting clinical preceptors shall be developed in writing. Competent
				clinicians can be considered qualified to be preceptors if they are:
(A) Licensed to practice as advanced practice
				registered nurses, or
(B) Currently
				licensed health care professionals who can provide supervision and teaching in
				clinical settings appropriate for advanced practice registered
				nursing.
(3) Written
				clinical objectives shall be specified and shared with the clinical preceptor
				prior to the experience.
(4) The
				designated faculty member shall be responsible for the student's learning
				experiences and shall communicate regularly with the clinical preceptor and
				student for the purpose of monitoring and evaluating learning experiences. If
				site visits are not feasible, communication and evaluation are managed by
				alternatives such as telephone, written communications, or clinical
				simulations.
Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 11 - TEXAS BOARD OF NURSING › Chapter 219 - ADVANCED PRACTICE NURSE EDUCATION › Section 219.11 - Facilities, Resources, and Services

Current through Reg. 49, No. 28; July 12, 2024
(a) The
				governing institution shall be responsible for providing:
(1) Educational facilities;
(2) Resources; and
(3) Services that support the effective
				development and implementation of the advanced practice registered nursing
				education program.
Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 11 - TEXAS BOARD OF NURSING › Chapter 219 - ADVANCED PRACTICE NURSE EDUCATION › Section 219.12 - Records and Reports

Current through Reg. 49, No. 28; July 12, 2024
(a) Accurate and
				current records shall be maintained in a confidential manner and be accessible
				to appropriate parties. Records shall include, but are not limited to:
(1) Records of current students;
(2) Transcripts/permanent record cards of
				graduates;
(3) Faculty
				records;
(4) Administrative records
				that include minutes of faculty meetings for the past three (3) years, annual
				reports of the program, and school catalogs;
(5) The current program of study and
				curriculum, including philosophy/mission and objectives/outcomes and course
				outlines;
(6) Agreements with
				affiliating agencies; and
(7)
				Master plan of evaluation with most recent data collection.
Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 11 - TEXAS BOARD OF NURSING › Chapter 219 - ADVANCED PRACTICE NURSE EDUCATION › Section 219.13 - Total Program Evaluation

Current through Reg. 49, No. 28; July 12, 2024
(a) There shall be
				a written plan for the systematic evaluation of the total program. The plan
				shall include evaluative criteria, methodology, frequency of evaluation,
				assignment of responsibility, and indicators (benchmarks) of program and
				instructional effectiveness. The following broad areas shall be periodically
				evaluated:
(1) Organization and administration
				of the program;
(2)
				Philosophy/mission and objectives/outcomes;
(3) Program of study, curriculum, and
				instructional techniques;
(4)
				Education facilities, resources, and services;
(5) Affiliating agencies and clinical
				learning activities;
(6) Student
				achievement, e.g., attrition rates, completion rates, length of time for
				program completion;
(7) Graduate
				outcomes, e.g., certification examination pass rates, graduate surveys,
				employer surveys; and
(8) Faculty's
				performance.
Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 11 - TEXAS BOARD OF NURSING › Chapter 220 - NURSE LICENSURE COMPACT › Section 220.1 - Eligibility and Compliance

Current through Reg. 49, No. 28; July 12, 2024
(a) Eligibility
				to hold a multistate licensure privilege under the Nurse Licensure Compact
				(Compact) shall be determined pursuant to the requirements of Texas Occupations
				Code §
									304.0015,
				Article III (c), and all uniform rules adopted by the Interstate Commission of
				Nurse Licensure Compact Administrators (Commission).
(b) All nurses granted a multistate licensure
				privilege under the Compact shall comply with all uniform rules adopted by the
				Commission, which are published on the Board's website.
Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 11 - TEXAS BOARD OF NURSING › Chapter 221 - ADVANCED PRACTICE NURSES › Section 221.2 - APRN Titles and Abbreviations

Current through Reg. 49, No. 28; July 12, 2024
(a) An
				advanced practice registered nurse (APRN) must be licensed in one or more of
				the following roles and population focus areas:
(1) Roles:
(A) Certified Nurse-Midwife (CNM);
(B) Certified Nurse Practitioner
				(CNP);
(C) Certified Registered
				Nurse Anesthetist (CRNA); and/or
(D) Clinical Nurse Specialist
				(CNS);
Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 11 - TEXAS BOARD OF NURSING › Chapter 221 - ADVANCED PRACTICE NURSES › Section 221.3 - APRN Education Requirements for Licensure

Current through Reg. 49, No. 28; July 12, 2024
(a) For purposes of this section, the
				following terms have the following meanings:
(1) Advanced Health Assessment Course--a
				course that offers content supported by related clinical experience such that
				students gain the knowledge and skills needed to perform comprehensive
				assessments to acquire data, make diagnoses of health status, and formulate
				effective clinical management plans. Content must include assessment of all
				human systems, advanced assessment techniques, concepts, and
				approaches.
(2) Advanced
				Pharmacotherapeutics Course--a course that offers content in pharmacokinetics
				and pharmacodynamics, pharmacotherapeutics of all broad categories of agents,
				and the application of drug therapy to the treatment of disease and/or the
				promotion of health.
(3) Advanced
				Physiology and Pathophysiology Course- a comprehensive, system-focused
				pathology course that provides students with the knowledge and skills to
				analyze the relationship between normal physiology and pathological phenomena
				produced by altered states across the life span.
(4) Role preparation--formal didactic and
				clinical experiences/content that prepares nurses to function in an APRN
				role.
(5) Clinical major
				courses--courses that include didactic content and offer clinical experiences
				in a specific population focus area.
(6)
				Practicum/Preceptorship/Internship/Residency/Fellowship--a designated portion
				of a formal APRN education program that is offered in a health care setting and
				affords students the opportunity to integrate theory and role in both the APRN
				role and population focus area through direct patient care/client management.
				Practicums/Preceptorships/Internships/Residencies/Fellowships are planned and
				monitored by either a designated faculty member or qualified
				preceptor.
Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 11 - TEXAS BOARD OF NURSING › Chapter 221 - ADVANCED PRACTICE NURSES › Section 221.4 - Licensure as an APRN

Current through Reg. 49, No. 28; July 12, 2024
(a) Application for
				Initial Licensure as an APRN.
(1) An
				applicant for licensure as an APRN in this state shall submit to the Board the
				required fee specified in §
										223.1 of this
				title (relating to Fees), verification of licensure or privilege to practice as
				a registered nurse in Texas, and a completed application that provides the
				following information:
(A) Graduation from an
				APRN graduate or post-graduate program, as evidenced by official documentation
				received directly from an APRN education program accredited by a nursing
				accrediting body that is recognized by the Board and the U.S. Secretary of
				Education and/or the Council for Higher Education Accreditation (CHEA), or its
				successor organization, as recognized by the Board; and
(B) Documentation of education shall verify
				the date of graduation; credential conferred; number of clinical hours
				completed; completion of three separate graduate level courses in advanced
				physiology and pathophysiology; advanced health assessment; advanced
				pharmacology that includes pharmacodynamics, pharmacokinetics, and
				pharmacotherapeutics of all broad categories of agents; role and population
				focus area of the education program; and evidence of meeting the standards of
				APRN education set forth in this rule.
Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 11 - TEXAS BOARD OF NURSING › Chapter 221 - ADVANCED PRACTICE NURSES › Section 221.5 - Acceptable Certification Examinations

Current through Reg. 49, No. 28; July 12, 2024
The Board shall determine whether a certification examination
				  may be used to satisfy a requirement for APRN licensure under this chapter
				  based upon the following standards:
(1) The certification program is national in
				the scope of its credentialing;
(2)
				Conditions for taking the certification examination are consistent with
				acceptable standards of the testing community and are intended to ensure
				minimal competence to practice at an advanced level of nursing;
(3) Education requirements are consistent
				with the requirements of the APRN role and population focus area;
(4) The standard methodologies used are
				acceptable to the testing community, such as incumbent job analysis studies and
				logical job analysis studies;
(5)
				Certification examinations are accredited by a national accreditation body as
				acceptable by the Board;
(6) The
				examination represents entry-level practice, with minimum, though critical
				competencies in the APRN role and population focus area;
(7) The examination represents the knowledge,
				skills, and abilities essential for the delivery of safe and effective advanced
				nursing care to patients;
(8)
				Examination items are reviewed for content validity, cultural bias, and correct
				scoring using an established mechanism, both before use and
				periodically;
(9) Examinations are
				evaluated for psychometric performance;
(10) The passing standard is established
				using acceptable psychometric methods and is re-evaluated
				periodically;
(11) Examination
				security is maintained through established procedures;
(12) Certification is issued based upon
				passing the examination and meeting all other certification
				requirements;
(13) A retake policy
				is in place;
(14) A certification
				maintenance/recertification program that includes review of qualifications and
				continued competence is in place;
(15) Mechanisms are in place for
				communication to the Board of timely verification of an individual's
				certification status, changes in certification status, and changes in the
				certification program, including qualifications, test plan, and scope of
				practice; and
(16) An evaluation
				process is in place to provide quality assurance in the certification
				program.
Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 11 - TEXAS BOARD OF NURSING › Chapter 221 - ADVANCED PRACTICE NURSES › Section 221.6 - Interim Approval

Current through Reg. 49, No. 28; July 12, 2024
(a) Interim
				approval is a time-limited permit to practice nursing in a specific advanced
				practice role and population-focus area. The Board may grant interim approval
				to eligible advanced practice registered nurse applicants.
(b) Interim approval permits the advanced
				practice registered nurse applicant to practice without prescriptive authority
				while the application is reviewed.
(1) The
				advanced practice registered nurse applicant who meets all requirements and
				applies for interim approval must complete documents provided by the Board
				attesting that:
(A) He/She meets all
				requirements for full licensure in an advanced practice registered nurse role
				and population-focus area in the state of Texas; and
(B) Has completed and submitted the
				appropriate documents to the advanced practice nursing educational program or
				designated organization for completion.
Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 11 - TEXAS BOARD OF NURSING › Chapter 221 - ADVANCED PRACTICE NURSES › Section 221.7 - Petitions for Waiver and Exemptions

Current through Reg. 49, No. 28; July 12, 2024
(a) A
				registered nurse who submits a request for waiver from requirements of this
				rule must submit documentation as required by the Board to support his or her
				petition and assure the Board that he or she possesses the knowledge, skills,
				and abilities appropriate for the role and population focus area of licensure
				desired. Those petitioners who are under investigation or current Board order
				are not eligible for waiver.
(b)
				Petitions for waiver from the program accreditation requirements set forth in
				this chapter may be granted by the Board for individuals who completed their
				APRN programs before January 1, 1996. Petitioners must meet the length of
				academic program requirements set forth in this chapter and provide evidence of
				current national certification in the APRN role and population focus
				area.
(c) Petitions for waiver from
				the current certification requirements of this chapter may be granted by the
				Board as follows:
(1) Applicants who
				completed their APRN education programs prior to January 1, 1996 may be granted
				an exemption from the national certification requirement, provided the program
				was accredited by a national nursing education accrediting body that is
				recognized by the Board and the U.S. Secretary of Education and/or the Council
				for Higher Education Accreditation (CHEA), or its successor organization, as
				acceptable to the Board at the time the applicant completed the program.
(2) Under this section, only those
				petitioners who completed their APRN education program on or after January 1,
				1996 for whom no national certification examination within the advanced role
				and population focus area or a related advanced specialty exists will be
				considered for waiver by the Board. The Board reserved the right to determine
				an appropriate alternate national certification examination for licensure in
				those specialty areas for which no specific examination existed for the
				specialty area.
(3) A written
				request for waiver of the national certification requirement must be
				submitted.
Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 11 - TEXAS BOARD OF NURSING › Chapter 221 - ADVANCED PRACTICE NURSES › Section 221.8 - APRN Licensure Renewal

Current through Reg. 49, No. 28; July 12, 2024
(a) In
				conjunction with Texas RN license renewal or at least on a biennial basis, an
				applicant for license renewal as an APRN shall submit to the Board the required
				nonrefundable fee for license renewal as specified in §
									223.1 of this
				title and a completed license renewal application.
(1) An applicant must provide a detailed
				explanation and supporting documentation for each affirmative answer to
				questions regarding the applicant's eligibility for licensure.
(2) An applicant must attest on forms
				provided by the Board to maintaining current national certification or
				recertification as applicable by the national professional certification
				organization that meets the requirements set forth in this rule and is
				recognized by the Board. This requirement shall apply to APRNs who:
(A) completed an APRN education program on or
				after January 1, 1996; or
(B) were
				licensed as APRNs based upon obtaining national certification.
(3) An applicant must attest, on
				forms provided by the Board, to having a minimum of 400 hours of current
				practice within the preceding biennium.
(4) An applicant must attest, on forms
				provided by the Board, to being in compliance with the requirements of Chapter
				216 and Chapter 222 of this title, where applicable.
Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 11 - TEXAS BOARD OF NURSING › Chapter 221 - ADVANCED PRACTICE NURSES › Section 221.9 - Inactive Status

Current through Reg. 49, No. 28; July 12, 2024
(a) An APRN may
				choose to change current APRN status to inactive status by providing a written
				request for such change. The APRN must meet the requirements of §
									217.9
				of this title (relating to Inactive and Retired Status) in order to place
				his/her license in inactive status.
(b) Inactive APRN status means that the
				registered nurse may not practice in the APRN role and may not hold
				himself/herself out to be an APRN by using any titles which imply that he/she
				is an APRN. Prescriptive authority shall be placed on inactive status
				concurrent with inactivation of the APRN license.
Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 11 - TEXAS BOARD OF NURSING › Chapter 221 - ADVANCED PRACTICE NURSES › Section 221.10 - Reactivation or Reinstatement of APRN Licensure

Current through Reg. 49, No. 28; July 12, 2024
(a) To reactivate a license that has expired
				due to non-renewal, the APRN shall meet the requirements for APRN licensure
				renewal and pay all required fees.
(b) If more than two years, but less than
				four years, have lapsed since completion of the APRN education program, and/or
				the applicant does not have 400 hours of current practice in the advanced role
				and population focus area during the previous biennium, the APRN shall meet the
				requirements for application for APRN licensure renewal and pay all required
				fees. The applicant shall be required to demonstrate proof of completion of 400
				hours of current practice in the APRN role and population focus area, as well
				as the continuing competency requirement as outlined in Chapter 216 of this
				title. The 400 hours of current practice shall be obtained under the direct
				supervision of a qualified preceptor who meets the requirements of subsection
				(c)(1)(C) of this section.
(c) If
				more than four years have lapsed since completion of the APRN education program
				and/or the applicant has not practiced in the advanced role and population
				focus area during the previous four years, the applicant shall apply for
				reactivation, meet current requirements for APRN licensure renewal; and
(1) successfully complete a refresher course
				or extensive orientation in the appropriate APRN population focus area and role
				that includes a supervised clinical component by a qualified preceptor who
				meets the requirements of subparagraph (C) of this paragraph.
(A) The course(s)/orientation shall be of
				sufficient length to satisfy the learning needs of the inactive APRN and to
				assure that he/she meets the minimum standard for safe, competent care. The
				course(s)/orientation shall cover the entire scope of the role and population
				focus area of licensure. Content shall comply with the requirements specified
				in the form titled "Requirements for APRN Refresher Course or Extensive
				Orientation", which is adopted by reference in paragraph (2) of this subsection
				and shall include satisfactory completion of 45 contact hours of
				pharmacotherapeutics.
(B) The
				preceptor must provide written verification of satisfactory completion of the
				course/orientation on forms provided by the Board and assurance that the
				individual has reviewed current practice-related information pertinent to
				his/her advanced role and population focus area.
(C) A preceptor must meet the following
				requirements:
(i) Holds an active, license as
				an APRN or physician that is not encumbered by a disciplinary order at a level
				that would prevent appropriate supervision and instruction;
(ii) Practices in a comparable practice focus
				area; and
(iii) Functions as a
				supervisor and teacher and evaluates the individual's performance in the
				clinical setting.
Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 11 - TEXAS BOARD OF NURSING › Chapter 221 - ADVANCED PRACTICE NURSES › Section 221.13 - Core Standards for Advanced Practice

Current through Reg. 49, No. 28; July 12, 2024
(a) The
				advanced practice nurse shall know and conform to the Texas Nursing Practice
				Act; current board rules, regulations, and standards of professional nursing;
				and all federal, state, and local laws, rules, and regulations affecting the
				advanced role and specialty area. When collaborating with other health care
				providers, the advanced practice nurse shall be accountable for knowledge of
				the statutes and rules relating to advanced practice nursing and function
				within the boundaries of the appropriate advanced practice category.
(b) The advanced practice nurse shall
				practice within the advanced specialty and role appropriate to his/her advanced
				educational preparation.
(c) The
				advanced practice nurse acts independently and/or in collaboration with the
				health team in the observation, assessment, diagnosis, intervention,
				evaluation, rehabilitation, care and counsel, and health teachings of persons
				who are ill, injured or infirm or experiencing changes in normal health
				processes; and in the promotion and maintenance of health or prevention of
				illness.
(d) When providing medical
				aspects of care, advanced practice nurses shall utilize mechanisms which
				provide authority for that care. These mechanisms may include, but are not
				limited to, Protocols or other written authorization. This shall not be
				construed as requiring authority for nursing aspects of care.
(1) Protocols or other written authorization
				shall promote the exercise of professional judgment by the advanced practice
				nurse commensurate with his/her education and experience. The degree of detail
				within protocols/policies/practice guidelines/clinical practice privileges may
				vary in relation to the complexity of the situations covered by such Protocols,
				the advanced specialty area of practice, the advanced educational preparation
				of the individual, and the experience level of the individual advanced practice
				nurse.
(2) Protocols or other
				written authorization:
(A) should be jointly
				developed by the advanced practice nurse and the appropriate
				physician(s),
(B) shall be signed
				by both the advanced practice nurse and the physician(s),
(C) shall be reviewed and re-signed at least
				annually,
(D) shall be maintained
				in the practice setting of the advanced practice nurse, and
(E) shall be made available as necessary to
				verify authority to provide medical aspects of care.
Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 11 - TEXAS BOARD OF NURSING › Chapter 221 - ADVANCED PRACTICE NURSES › Section 221.14 - Nurse-Midwives Providing Controlled Substances

Current through Reg. 49, No. 28; July 12, 2024
(a) In this section "provide" means to
				supply, for a term not to exceed 48 hours, one or more unit doses of a
				controlled substance for the immediate needs of a patient;
(b) An advanced practice registered nurse
				recognized by the Board as a nurse-midwife may provide one or more unit doses
				of a controlled substance during intra-partum or immediate post-partum care
				subject to the following conditions:
(1)
				Physician delegation of authority to provide controlled substances must be made
				through a physician's order, medical order, standing delegation order,
				prescriptive authority agreement, or protocol that requires adequate and
				documented availability for access to medical care. Delegation may not include
				the use of a prescription sticker or the use or issuance of an official
				prescription form or the authority to issue an electronic prescription under
				§
										481.075,
				Health and Safety Code;
(2) The
				physician's orders, medical orders, standing delegation orders, prescriptive
				authority agreements, or protocols must require the reporting of or monitoring
				of each patient's progress, including complications of pregnancy and delivery
				and the administration and provision of controlled substances by the
				nurse-midwife to the patient;
(3)
				Delegation is limited to seven nurse-midwives or physician assistants or their
				full-time equivalents and the designated facility at which the nurse-midwife or
				physician assistant provides care; and
(4) The controlled substance must be supplied
				in a suitable container that is labeled in compliance with the applicable drug
				laws and must include:
(A) the patient's name
				and address;
(B) the drug to be
				provided;
(C) the name, address,
				and telephone number of the physician;
(D) the name, address, and telephone number
				of the nurse-midwife; and
(E) the
				date.
Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 11 - TEXAS BOARD OF NURSING › Chapter 221 - ADVANCED PRACTICE NURSES › Section 221.15 - Provision of Anesthesia Services by Nurse Anesthetists in Licensed Hospitals or Ambulatory Surgical Centers

Current through Reg. 49, No. 28; July 12, 2024
(a) In a
				licensed hospital or ambulatory surgical center, consistent with facility
				policy or medical staff bylaws, a nurse anesthetist may select, obtain, and
				administer drugs including determination of appropriate dosages, techniques and
				medical devices for their administration and in maintaining the patient in
				sound physiologic status pursuant to a physician's order for anesthesia or an
				anesthesia-related service. This order need not be drug specific, dosage
				specific, or administration-technique specific.
(b) Pursuant to a physician's order for
				anesthesia or an anesthesia-related service, the nurse anesthetist may order
				anesthesia-related medications during perianesthesia periods in the preparation
				for or recovery from anesthesia. Another RN may carry out these
				orders.
(c) In providing anesthesia
				or an anesthesia-related service, the nurse anesthetist shall select, order,
				obtain and administer drugs which fall within categories of drugs generally
				utilized for anesthesia or anesthesia-related services and provide the
				concomitant care required to maintain the patient in sound physiologic status
				during those experiences.
Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 11 - TEXAS BOARD OF NURSING › Chapter 221 - ADVANCED PRACTICE NURSES › Section 221.16 - Provision of Anesthesia Services by Nurse Anesthetists in Outpatient Settings

Current through Reg. 49, No. 28; July 12, 2024
(a) Purpose. The
				purpose of these rules is to identify the roles, and responsibilities of
				certified registered nurse anesthetists authorized to provide anesthesia
				services in outpatient settings and to provide the minimum acceptable standards
				for the provision of anesthesia services in outpatient settings.
(1) On or after August 31, 2000 certified
				registered nurse anesthetists shall comply with subsections (b)(2)-(e) of this
				section in order to be authorized to provide general anesthesia, regional
				anesthesia, or monitored anesthesia care in outpatient settings. This
				requirement shall include certified registered nurse anesthetists administering
				any inhaled anesthetic agents, including, but not limited to, nitrous oxide,
				due to the significant variability in patient response to such drugs.
(2) Subsections (b)(2)-(e) of this section do
				not apply to the registered nurse anesthetist who practices in the following:
(A) an outpatient setting in which only local
				anesthesia, peripheral nerve blocks, or both are used;
(B) an outpatient setting in which only
				anxiolytics and analgesics are used and only in doses that do not have the
				probability of placing the patient at risk for loss of the patient's
				life-preserving protective reflexes;
(C) a licensed hospital, including an
				outpatient facility of the hospital that is separately located apart from the
				hospital;
(D) a licensed ambulatory
				surgical center;
(E) a clinic
				located on land recognized as tribal land by the federal government and
				maintained or operated by a federally recognized Indian tribe or tribal
				organization as listed by the United States secretary of the interior under 25
				U.S.C. Section 479-1 or as listed under a successor federal statute or
				regulation
(F) a facility
				maintained or operated by a state or governmental entity;
(G) a clinic directly maintained or operated
				by the United States or by any of its departments, officers, or agencies;
				and
(H) an outpatient setting
				accredited by
(i) the Joint Commission on
				Accreditation of Healthcare Organizations relating to ambulatory surgical
				centers;
(ii) the American
				Association for the Accreditation of Ambulatory Surgery Facilities,
(iii) the Accreditation Association for
				Ambulatory Health Care.
Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 11 - TEXAS BOARD OF NURSING › Chapter 221 - ADVANCED PRACTICE NURSES › Section 221.17 - Enforcement

Current through Reg. 49, No. 28; July 12, 2024
(a) The board may conduct an audit to
				determine compliance with §
									221.4
				of this chapter (relating to Requirements for Full Authorization to Practice),
				§
									221.8
				of this chapter (relating to Maintaining Active Authorization as an Advanced
				Practice Nurse), and §
									221.16
				of this chapter (relating to Provision of Anesthesia Services by Nurse
				Anesthetists in Outpatient Settings).
(b) Any nurse who violates the rules set
				forth in this chapter shall be subject to disciplinary action and/or
				termination of the authorization by the board under Texas Occupations Code,
				§
									301.452.
Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 11 - TEXAS BOARD OF NURSING › Chapter 222 - ADVANCED PRACTICE REGISTERED NURSES WITH PRESCRIPTIVE AUTHORITY › Section 222.1 - Definitions

Current through Reg. 49, No. 28; July 12, 2024
The following words and terms when used in this chapter shall
				  have the following meanings unless the context clearly indicates
				  otherwise:
(1) Advanced health
				assessment--A course that offers content supported by related clinical
				experience such that students gain the knowledge and skills needed to perform
				comprehensive assessments to acquire data, make diagnoses of health status, and
				formulate effective clinical management plans. Content must include assessment
				of all human systems, advanced assessment techniques, concepts, and
				approaches.
(2) Advanced
				Pharmacotherapeutics--A course that offers advanced content in
				pharmacokinetics, pharmacodynamics, pharmacotherapeutics of all broad
				categories of agents, and the application of drug therapy to the treatment of
				disease and/or the promotion of health.
(3) Advanced Physiology and
				Pathophysiology--A dedicated, comprehensive, system-focused pathology course(s)
				that provides students with the knowledge and skills to analyze the
				relationship between normal physiology and pathological phenomena produced by
				altered states across the life span.
(4) Advanced practice registered nurse
				(APRN)--As defined by §
									301.152,
				Occupations Code. The term includes an advanced nurse practitioner and advanced
				practice nurse.
(5) Board--The
				Texas Board of Nursing.
(6)
				Controlled Substance--As defined by §
									481.002, Health and
				Safety Code.
(7) Dangerous Drug--As
				defined by §
									483.001, Health and
				Safety Code.
(8) Device--As defined
				by §
									551.003, Occupations
				Code, and includes durable medical equipment.
(9) Diagnosis and management course--A course
				offering both didactic and clinical content in clinical decision-making and
				aspects of medical diagnosis and medical management of diseases and conditions.
				Supervised clinical practice must include the opportunity to provide
				pharmacological and non-pharmacological management of diseases and conditions
				considered within the scope of practice of the APRN's population focus area and
				role.
(10) Facility-based
				practice--A hospital, as defined by §
									157.051(6),
				Occupations Code, or a licensed long term care facility. A facility based
				practice does not include a freestanding clinic, center, or other medical
				practice associated with or owned or operated by a hospital or licensed long
				term care facility.
(11) Health
				professional shortage area--
(A) An urban or
				rural area of this state that:
(i) is not
				required to conform to the geographic boundaries of a political subdivision but
				is a rational area for the delivery of health services;
(ii) the Secretary of Health and Human
				Services determines has a health professional shortage; and
(iii) is not reasonably accessible to an
				adequately served area;
Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 11 - TEXAS BOARD OF NURSING › Chapter 222 - ADVANCED PRACTICE REGISTERED NURSES WITH PRESCRIPTIVE AUTHORITY › Section 222.2 - Approval for Prescriptive Authority

Current through Reg. 49, No. 28; July 12, 2024
(a) To
				be issued a prescription authorization number to prescribe or order a drug or
				device, a registered nurse (RN) shall:
(1)
				have full licensure from the Board to practice as an APRN. RNs with Interim
				Approval to practice as APRNs are not eligible for prescriptive authority;
				and
(2) file a complete application
				for Prescriptive Authority and submit such evidence as required by the Board to
				verify successful completion of graduate level courses in advanced
				pharmacotherapeutics, advanced pathophysiology, advanced health assessment, and
				diagnosis and management of diseases and conditions within the role and
				population focus area.
(A) Nurse
				Practitioners, Nurse-Midwives, and Nurse Anesthetists will be considered to
				have met the course requirements of this section on the basis of courses
				completed in the advanced practice nursing educational program.
(B) Clinical Nurse Specialists shall submit
				documentation of successful completion of separate, dedicated, graduate level
				courses in the content areas described in paragraph (2) of this subsection.
				These courses shall be academic courses with a minimum of 45 clock hours per
				course from a nursing program accredited by an organization recognized by the
				Board.
(C) Clinical Nurse
				Specialists who were previously approved by the Board as APRNs by petition on
				the basis of completion of a non-nursing master's degree shall not be eligible
				for prescriptive authority.