Texas Register, Volume 22, Number 80, Pages 12189-12342, December 12, 1997 Page: 12,207
12189-12342 p. ; 28 cm.View a full description of this periodical.
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Katherine A. Thomas, MN, RN, executive director, has deter-
mined that there will be no fiscal implications for state or local
government as a result of enforcing or administering the rule.
There will be no effect on local government nor businesses to
comply with the rule.
Katherine A. Thomas, MN, RN, executive director, has deter-
mined that for each year of the first five years the rule as pro-
posed will be in effect the public has increased assurance that
the APN and the physician will review their protocols/ policies/
practice guidelines more frequently, thus assuring better protec-
tion of the public.
Written comments on the proposed amendment may be sub-
mitted to Sally Glaze, Board of Nurse Examiners, Post Office
Box 430; Austin, Texas 78767-0430.
The amendments are proposed under the Nursing Practice
Act, (Texas Civil Statutes, Article 4514), 1, which provides
the Board of Nurse Examiners with the authority and power
to make and enforce all rules and regulations necessary for the
performance of its duties and conducting of proceedings before
it and Article 4514, 8, which provides the Board of Nurse
Examiners the authority and power to adopt rules for approval
of a registered nurse to practice as an advanced practice nurse.
There are no other rules, codes, or statutes that will be affected
by this proposal.
221.1. Definitions.
The following words and terms, when used in this chapter, shall have
the following meanings unless the context clearly indicates otherwise:
"Protocols or other orders" [Protools/policies/practice guidelines] -
Written authorization to initiate medical aspects of patient care which
are agreed upon and signed by the APN [ Advanced Practice Nurse]
and the physician, reviewed and signed at least annually [biennially],
and maintained in the practice setting of the APN [Advanced Practice
Nurse]. Protocols or other orders shall be defined to promote the
exercise of professional judgment by the APN commensurate with
his/her education and experience. Such protocols or other orders
need not describe the exact steps that the APN must take with respect
to each specific condition, disease, or symptom and may state types
or categories of drugs which may be prescribed rather than just list
specific drugs.
221.12. Functions.
(a)-(b) (No change.)
(c) Advanced practice nurses must utilize mechanisms which
provide medical authority when such mechanisms are indicated.
These mechanisms may include but are not limited to protocols
[protocols/policies/practice l guidelines] or other orders. This shall not
be construed as requiring authority for nursing aspects of care.
(1) When protocols or other orders [pretoeols/policies/
p .aetiee gt~deli~ne] are used to provide such authorization they should
be jointly developed by the APN [Advanced Practie Nurse] and
appropriate physician(s) and signed by both the APN [Advaneed
Practice Nurse] and the physician(s). These protocols or other
orders [prot1ocols/policies/practice guidelines] shall be reviewed at
least annually and maintained in the practice setting of the APN
(2) (No change.)
(d) (No change.)This agency hereby certifies that the proposal has been re-
viewed by legal counsel and found to be within the agency's
legal authority to adopt.
Issued in Austin, Texas, on November 25, 1997.
TRD-9715902
Katherine A. Thomas, MN, RN
Executive Director
Board of Nurse Examiners
Earliest possible date of adoption: January 12, 1998
For further information, please call: (512) 305-6811
Chapter 222. Advanced Practice Nurses with
Limited Prescriptive Authority
22 TAC 222.1
The Board of Nurse Examiners proposes an amendment to
222.1, concerning Definitions.
The amendment is being proposed to bring the Board's rules
into compliance with statutes and expands the practice scope of
advanced practice nurses. During the 75th Legislative Session,
House Bill 2846 was passed relating to the provisions of health
care services by advanced practice nurses including expansion
of sites for limited prescriptive authority. Specifically, the law
amended the definition of physician's primary practice site to
include "a clinic operated by or for the benefit of a public school
district for the purpose of providing care to the students of that
district and the siblings of those students, if consent to treatment
at that clinic is obtained."
Katherine A. Thomas, MN, RN, executive director, has deter-
mined that there will be no fiscal implications for state or local
government as a result of enforcing or administering the rule.
There will be no effect on local government nor businesses to
comply with the rule.
Ms. Thomas also has determined that for each year of the
first five years the rule as proposed will be in effect the public
has expanded access to health care through the addition of the
definition of primary practice site to include the public school
district clinics.
Written comments on the proposed amendment may be sub-
mitted to Sally Glaze, Board of Nurse Examiners, Post Office
Box 430; Austin, Texas 78767-0430.
The amendments are proposed under the Nursing Practice
Act, (Texas Civil Statutes, Article 4514), 1, which provides
the Board of Nurse Examiners with the authority and power
to make and enforce all rules and regulations necessary for the
performance of its duties and conducting of proceedings before
it and Article 4514, 8, which provides the Board of Nurse
Examiners the authority and power to adopt rules for approval
of a registered nurse to practice as an advanced practice nurse.
There are no other rules, codes, or statutes that will be affected
by this proposal.
222.1. Definitions.
The following words and terms, when used in this chapter, shall have
the following meanings unless the context clearly indicates otherwise:
"Physician's primary practice site" - Any one of the following:
(A) (No change.)PROPOSED RULES December 12, 1997 22 TexReg 12207
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Texas. Secretary of State. Texas Register, Volume 22, Number 80, Pages 12189-12342, December 12, 1997, periodical, December 12, 1997; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth176721/m1/21/: accessed July 18, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.