April 2024 Board of Nursing Bulletin

Comment on the Board of Nursing - Take the BON Online Survey

The Board of Nursing (BON or Board) would like your input! The Legislative Budget Board (LBB) has published the instructions for state agencies for Strategic Plan submission to the Texas Legislature in June 2024. LBB instructions included eight questions related to Customer Service covering topics including: satisfaction with the agency's facilities, agency communications, website, complaint handling process, printed publications, and overall satisfaction with the agency. The survey may be completed in five minutes or less. The link to the survey is located on the home page of the BON website at www.bon.texas.gov. Data will be collected through April 20, 2024, so you must act quickly to participate in the survey. Please take a few minutes to complete the survey so your input can be used to make improvements aimed to meet the agency mission of public protection.

Looking Back at 2023: A Year of Growth and Change

In this issue of the Bulletin, the 2023 Texas Board of Nursing (BON or Board) Annual Report is featured. As the BON prepares for the 89th Texas Legislative Session, information in the report provides a picture of: the nursing population, pass rates for graduates of Texas nursing education programs, growth seen in new education programs, enforcement actions taken by the Board, and challenges facing the profession such as fraudulent education programs. The Annual Report is shared with the Texas Legislature and helps to cast light on work performed by the agency. Staff will begin preparing the 2024 Annual Report in December and will share the report with the Board in January 2025 as the 89th Texas Legislative Session convenes.

The Texas Board of Nursing

BOARD MEMBERS

Officers

Kathy Shipp, MSN, APRN, FNP President, representing Advanced Practice Nursing Lubbock

Allison Porter-Edwards, DrPH, MS, RN, CNE, FAAN Vice-President, representing BSN Education Bellaire

Members

Kathy Boswell, MS, RN representing ADN Education Mineral Wells

Daryl Chambers, BBA representing Consumers Grand Prairie

Laura Disque, MSN, RN, CGRN representing RN Practice Edinburg

Carol Kay Hawkins-Garcia, BSN, RN representing RN Practice San Antonio

Mazie M. Jamison, BA, MA representing Consumers Dallas

Kenneth D. "Ken" Johnson, RN representing LVN Education San Angelo

Kathy Leader-Horn, LVN representing LVN Practice Granbury

Dru Riddle, PhD, APRN, CRNA representing APRN Practice Fort Worth

Melissa D. Schat, LVN representing LVN Practice Granbury

Rickey "Rick" Williams, AA representing Consumers Killeen

Kimberly L. "Kim” Wright, LVN representing LVN Practice Big Spring

Executive Director

Kristin K. Benton, DNP, RN

The Texas Board of Nursing Bulletin is the official publication of the Texas Board of Nursing and is published four times a year: January, April, July, and October.

Published by:

TEXAS BOARD OF NURSING

VOLUME LV - No. 2

Publication Office:

1801 Congress Avenue, Suite 10-200

Austin, Texas 78701-3944

Phone: (512) 305-7400

Fax: (512) 305-7401

Publication Date: 3/29/2024

In the January 19, 2024, edition of the Texas Register, the Board of Nursing (BON or Board) filed a notice of intention to review and consider for re-adoption, re-adoption with amendments, or repeal, the following chapters contained in Title 22, Part 11, of the Texas Administrative Code (TAC), pursuant to the 2022 rule review plan adopted by the Board at its April 2022 meeting, in the November 24, 2023, issue of the Texas Register (48 TexReg 6921).

Chapter 211. General Provisions, §§211.1 - 211.11

Reviewed Reports:

Summary of Actions

Chapter 217. Licensure, Peer Assistance, and Practice §§217.1217.24 and

Chapter 219. Advanced Practice Registered Nurse Education §§219.1 - 219.13

The Board received no comments on the above rules. The Board has completed its review and has determined that the reasons for originally adopting the above rules continue to exist. The rules were also reviewed to determine whether they were obsolete, whether they reflected current legal and policy considerations and current proce-

dures and practices of the Board, and whether they were in compliance with Texas Government Code (TGC) Chapter 2001 (Texas Administrative Procedure Act). The Board found that the rules were not obsolete, reflect current legal and policy considerations, current procedures and practices of the Board, and that the rules are in compliance with the Texas Administrative Procedure Act. The Board readopts the rules in Chapters 211, 217, and 219 without changes, pursuant to the TGC §2001.039 and Texas Occupations Code (TOC)

continued on page 19

Nursing Education Actions - January 2024 Board Meeting

Five-Year Report on New Nursing Programs and Currently Active Proposals

Status Report on Programs with Sanctions

Report on Communication Activities with Nursing Education Programs

Approved Reports of Survey Findings:

• The Vocational Nursing Institute, Inc., in Houston – Vocational Nursing (VN) Program

• Rio Grande Valley College in Pharr – VN Program

• Rio Grande Valley College in Pharr – Associate Degree Nursing (ADN) Program

• Dallas College at El Centro in Dallas – VN Program

• South Plains College in Levelland – ADN Program

• Galen College of Nursing in San Antonio – ADN Program

• Baptist Health System School of Health Professions in San Antonio – VN Program

• Lamar State College Orange in Orange – VN Program

• Houston Community College in Houston – VN Program

• Concord Career College in Grand Prairie – VN Program

• College of the Mainland in Texas City – VN Program

Approved Notification of Closure of Programs:

• Houston Community College in

Houston – ADN Program

Approved Proposal to Establish a New Nursing Education Program:

• St. Mary’s University in San Antonio - Baccalaureate Degree Nursing Program

• Palo Alto College in San Antonio – ADN Program

• CTK Healthcare & Career Institute in Irving – VN Program

• Schreiner University in Kerrville – Master of Science in Nursing Family Nurse Practitioner Program

Approved Change in Approval from Conditional to Full Approval:

• Clarendon College in Childress – ADN Program

• South Plains College in Levelland – VN Program

A regular meeting of the Board of Nursing was held January 25-26, 2024, in Austin. The following is a summary of Board actions taken during this meeting.

EDUCATION REQUIREMENT

Minimum of a BSN from a professional nursing program and actively enrolled in an approved or accredited MSN program, working towards an MSN. Masters degree in nursing is preferred

LICENSURE REQUIREMENT

Do you have a passion for protecting the public?

Have you reached a point in your career where you are ready to apply your nursing experience on a broader level to protect the public of Texas? If so, a career in nursing regulation may be for you!

The Texas Board of Nursing is hiring for the Nursing Consultant for Practice position. The role requires the following knowledge, skills, and abilities:

• Personal and professional integrity, possessing strong ethical standards and honesty

Current, unencumbered, RN license issued by the Texas Board of Nursing, or eligible for RN licensure in Texas

PRACTICE REQUIREMENT

• Accountability for one’s own professional actions and development with a deep sense of responsibility for the professional aspects of state board work

• Use of sound judgment, consideration of issues with objectivity, and application of standards for decision-making with consistency

Broad experience in various professional nursing positions, with at least 3 years in patient care

LOCATION REQUIREMENT

Position is based in Austin, TX, with in-office requirements

DESIRED AT TRIBUTES

• Comprehensive knowledge of general nursing and a broad understanding of the nursing profession

• High degree of skill in methods of written and verbal communication; articulate speaker; excellent communication and delivery skills to both large and small audiences, and the ability to adapt to the audience at hand; capabale of writting professional reports suitable for public distribution

• Capacity to analyze and synthesize information in a short period of time, organize and accomplish work efficiently, and effectively manage multiple high priority projects with minimal direction

If a career in nursing regulation is for you, please visit:

,

Excellent communication skills, willingness to learn, respect for due process and a sense of justice, flexible, organized, teamoriented, analytic thinking, commitment to safety

https://www.bon.texas.gov/about_careers.asp.html

This page includes:

• Job Description

• Instructions for Completing State of Texas Application for Employment

• State of Texas Application for Employment

New Education Guideline Launched: Including Long-term Care Facilities Among Settings for Clinical Learning Activities

The dynamic field of nursing education is constantly evolving to meet the demands of the changing healthcare landscape. As healthcare continues to advance, people are living longer and the need for skilled and compassionate healthcare professionals in long-term care (LTC) facilities has become increasingly important. The report titled Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity reinforced that “nurses will need to be educated to care for a population that is both aging, with declining mental and physical health, and becoming increasingly diverse” (National Academies of Sciences, Engineering, and Medicine, 2021).

Collaborative efforts between the Texas Board of Nursing (BON or Board) and the Texas Health and Human Services Commission (TX HHSC) reviewed current nursing education programs and evaluated how these programs could be used to meet professional nursing standards and benefit care provided to the patient populations living in LTC facilities. This collaboration led to the development of a new education guideline for nursing education programs: 3.7.8 Education Guideline - Including Longterm Care Facilities Among Settings for Clinical Learning Activities. Through this guideline, the BON encourages all nursing programs providing LVN and RN education to utilize LTC settings for clinical experiences so that all students will be exposed to the practice setting at some point in the education program.

Board Rules on Clinical Experiences

The Board does not specify a clinical hour requirement for any specific setting. Board Rule 214.9(c)(3) for vocational nursing education and Board Rule 215.9(c) (4) for professional nursing education state that hours in clinical learning experiences shall be sufficient to meet program of study requirements with a rationale for the ratio of contact hours assigned to classroom and clinical learning experiences. The Board requires clinical learning experiences with the geriatric population but is not prescriptive about in which settings.

Why incorporate Long-Term Care (LTC) settings into nursing school curriculum?

The underutilization of LTC facilities as clinical practice settings may be due to perceptions that these facilities are less demanding or complex than acute care settings (i.e., hospitals), and they lack challenging learning opportunities (Iheduru-Anderson, 2015; Splitgerber, et al., 2021). Similarly, LTC facilities may be hesitant to allow nursing students to work with their residents or view students as an additional stressor (Iheduru-Anderson, 2015). However, working relationships between an LTC facility and a nursing education program can be mutually beneficial among all parties involved including aspiring nurses, residents living in an LTC facility, and LTC facility staff.

Student benefits: Students are provided with a variety of learning opportunities which offers a stable foundation and successful transition into the nursing profession. The experience of day-to-day operations of an LTC facility provides students with an integrated understanding of residential care, one that goes beyond the episodic nature of acute care. Clinical experiences in LTC settings can provide valuable benefits for student nurses, such as:

• Involvement in the provision of care on an ongoing basis throughout the resident’s aging process for both urgent and chronic health conditions (DunbarJacob and Fulmer, 2023; Splitgerber, et al, 2021),

• enhancement of skills related to performing focused and comprehensive assessments, developing care plans, and providing health education (IheduruAnderson, 2015),

• interdisciplinary collaboration among other healthcare team members (Dunbar-Jacob and Fulmer, 2023; Iheduru-Anderson, 2015),

• exposure to nurse leadership roles and leadership techniques to manage adequate staffing levels and determine which continued on next page

tasks can be assigned or delegated (DunbarJacob and Fulmer, 2023; Splitgerber, et al, 2021), and

• the exposure to aspects of holistic care beyond immediate medical needs, such as resident wellbeing and quality of life (Splitgerber, et al, 2021).

Resident benefits: LTC residents measure the quality of care in nursing homes by several parameters, such as autonomy, social relationships, joy of life, and meaningful activities (Haugland and Giske, 2021). This population can also be prone to loneliness and isolation. Studies have suggested that the relational qualities of the nurse-patient interaction are key to the residents’ sense of self-worth and well-being. Nursing students in LTC facilities supplement staffing levels, allowing for greater time spent with the residents and their families. Other additional benefits include:

• having a nursing student as an additional caretaker and advocate for safe resident care and quality of life,

• creativity and updates to evidence-based nursing practices can lead to positive health outcomes, and

• meaningful engagement, including indoor and outdoor activities that provide a sense of home for LTC facility residents.

LTC Staff benefits: just like other healthcare settings, LTC facilities experience staffing shortages and sometimes struggle to find sufficient staff and retain the staff they have. Nursing education programs have a special opportunity to support and assist LTC facility staff and improve health inequity issues within their communities through clinical experiences in LTCs. LTC staff benefits could include:

• an increase in the volume of qualified caretakers,

• opportunity for LTC facility staff to evaluate current policies, develop new quality improvement initiatives, and provide staff training to meet resident needs, and

• the chance to promote and engage future nurses in the LTC setting (Farsetta, 2015; Splitgerber, et al, 2021).

Please visit https://www.bon. texas.gov/pdfs/education_pdfs/ education_nursing_guidelines/37-8-Guideline.pdf to see 3.7.8 Education Guideline - Including Long-term Care Facilities Among Settings for Clinical Learning Activities guideline for more information, including suggestions for students to participate in the LTC practice setting. Keep in mind, this is not an exhaustive list, and these don’t have to be formal clinical experiences.

Nursing education programs are obligated to prepare students for the diverse challenges they may encounter in their careers. Incorporating LTC training is a strategic

investment in preparing future nurses for a seamless transition into the nursing profession, as well as meeting the growing needs of our healthcare system.

References

Dunbar-Jacob, J. and Fulmer, T. (2023). Nursing homes for nursing education. J Prof Nurs. 2023 MayJune; 46: A1-A2; doi: 10.1016/j. profnurs.2023.03.019

Farsetta, D. (2015). Introducing Nursing Students to Long-Term Care. Center for Aging Research and Education. CARE at the UW-Madison School of Nursing. https://care.nursing.wisc. edu/2015/07/11/introducingnursing-students-to-long-termcare/

Haugland B., and Giske, T. (2021). Nursing Students Explore Meaningful Activities for Nursing Home Residents: Enlivening the Residents by Cultivating Their Spark of Life. Nurs Resp. 2021 Jun; 11(2): 217228. doi: 10.3390/nursrep11020022

Iheduru-Anderson, K. (2015). Why long-term care is an excellent clinical learning environment. American Nurse Today. Volume 10, Number 5. https://www.myamericannurse.com/long-term-care-excellent-clinical-learning-environment/

National Academies of Sciences, Engineering, and Medicine. (2021). The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity. Washington, DC:

continued on next page

The National Academies Press. https://doi.org/10.17226/25982.

Splitgerber, H., Davies, S., and Laker, S. (2021). Improving clinical experiences for nursing students in nursing homes: An integrative literature review. Nurse Education in Practice. Volume 52, March 2021, 103008. https://www.sciencedirect.com/science/article/abs/pii/ S1471595321000445

Additional Resources

• Advancing Care Excellence for Seniors (ACES), National

League for Nursing. https:// www.nln.org/education/ teaching-resources/ professional-developmentprogramsteachingresourcesace-all/ace-s

• Johnson-Turpin Center for Gerontological Nursing, University of Texas at Austin School of Nursing, https://nursing.utexas. edu/research/luci-bainesjohnson-and-ian-j-turpincenter-gerontologicalnursing

• Long Term Care Facilities. Centers for Medicare & Medicaid Services (CMS).

https://www.cms.gov/ medicare/health-safetystandards/conditionscoverage-participation/ long-term-care

• Long-term Care Providers. Texas Health and Human Services Commission.

https://www.hhs.texas. gov/providers/long-termcare-providers

TEXAS BOARD OF NURSING 2023 ANNUAL REPORT

BOARD MEMBERS

Kathy Shipp, President, MSN, APRN, FNP, Representing APRN Practice, Lubbock

Allison Porter-Edwards, DrPH, MS, RN, CNE, FAAN, Vice President, Representing BSN Education, Bellaire

Kathy Boswell, MS, RN, Representing ADN Education, Mineral Wells

Daryl Chambers, BBA, Consumer Member, Grand Prairie

Laura Disque, MSN, RN, CGRN, Representing RN Practice, Edinburg

Carol Kay Hawkins-Garcia, BSN, RN, Representing RN Practice, San Antonio

Mazie M. Jamison, BA, MA, Consumer Member, Dallas

Kenneth D. Johnson, RN, Representing LVN Education, San Angelo

Kathy Leader-Horn, LVN, Representing LVN Practice, Granbury

Dru Riddle, PhD, APRN, CRNA, Representing APRN Practice, Fort Worth

Melissa D. Schat, LVN, Representing LVN Practice, Granbury

Rickey “Rick” Williams, AA, Consumer Member, Killeen

Kimberly L. “Kim” Wright, LVN, Representing LVN Practice, Big Spring

NUMBER

RNS/LVNS/APRNS IN TEXAS: FY 2019-2023

The number of nurses holding current LVN licensure declined from the past fiscal year by 0.53%. The average annual growth in RN licensure was 5.69% with growth in APRN licensure averaging 14%.

The RN population experienced growth in both licensure by examination and endorsement and the growth of APRNs increased steadily over the past five years.

TEXAS BOARD OF NURSING REVENUE/ EXPENDITURES: FY 2019-2023

The continued growth in licensees in Texas has resulted in higher revenue from license renewals. The BON attempts to maintain a balance of funds approved by the Texas Legislature but the sustained growth of RNs and APRNs provided additional revenue beyond projections.

NURSES WITH CURRENT DISCIPLINE: FY 2023

PERCENTAGE OF CASES COMPARED TO TOTAL POPULATION OF LICENSEES

Current discipline affects a very small population of nurses – only 0.28% of Registered Nurses, 0.60% of Licensed Vocational Nurses and 0.27% of Advanced Practice Registered Nurses have current discipline as of the end of FY 2023.

TYPES OF CASES RESULTING IN DISCIPLINE: FY 2023

PERCENTAGE OF TOTAL COMPLAINT TOPICS RESULTING IN DISCIPLINE

Over half (62%) of complaints resulting in discipline included concerns about use of drugs/ alcohol, fitness to practice, deception, and misappropriation, while concerns involving nursing practice issues represented 21% of the complaints.

Note: Cases may include more than one type of conduct.

PERCENTAGE OF CASES CLOSED IN SIX MONTHS: FY 2019-2023

PROGRAM NURSING

BACCALAUREATE NURSING PROGRAMS

VOCATIONAL NURSING PROGRAMS

ASSOCIATE DEGREE NURSING PROGRAMS

From FY 2019-2023, the BON approved 20 new nursing education programs: 7 were baccalaureate degree, 6 were associate degree, and 7 were vocational certificate.

TEXAS NURSING EDUCATION PROGRAM NCLEX® PASS RATES COMPARED TO NATIONAL PASS RATES: FY 2018-2022

The annual NCLEX-RN® and NCLEX-PN® examination pass rates of first time test-takers from registered nursing and vocational nursing programs in Texas have continued to be above the national average since 2018.

I. Agency Mission and Values of the Texas Board of Nursing

The mission of the Texas Board of Nursing (BON or Board) is to protect and promote the welfare of the people of Texas by ensuring that each person holding a license as a nurse in the State of Texas is competent to practice safely. The Board fulfills its mission through the regulation of the practice of nursing and the approval of nursing education programs. This mission, derived from the Nursing Practice Act (NPA), supersedes the interest of any individual, the nursing profession, or any special interest group.

II. Legal/Enforcement Highlights

Number of New Cases – Investigator Caseloads

In FY 2023, the Board opened 20,451 new cases, which was 736 fewer cases than opened in FY 2022. In comparison, the most significant contributors to the increased cases in FY 2022 were the completion of a retrospective administrative review of renewal applications submitted during the first 10 months of using the new licensure system along with significant increases in the number of student background checks and rap back reports. The number of student background checks and rap back reports has increased by 26%, with 5,806 reports reviewed in FY 2022 and 7,356 in FY 2023.

Prior to FY 2019, the Board had routinely been closing more cases each year than were opened. In FY 2023, as in the four prior fiscal years, the Board closed fewer cases than new cases opened, likely due to vacant investigator positions and continued delays in obtaining records post pandemic. By the end of FY 2023, the average investigator caseload increased by 20.6% to 158 cases per investigator.

Disciplinary Actions

The percent of complaints resulting in discipline increased slightly from 8.1% in FY 2022 to 8.2% in FY 2023.

Acting in accordance with the highest standards of ethics, accountability, efficiency, effectiveness, and openness, the Texas Board of Nursing approaches its mission with a deep sense of purpose and responsibility and affirms that the regulation of nursing is a public and private trust. The Board assumes a proactive leadership role in regulating nursing practice and nursing education. The Board serves as a catalyst for developing partnerships and promoting collaboration in addressing regulatory issues. The public and nursing community alike can be assured of a balanced and responsible approach to regulation.

Informal Settlement Conferences – Mediations - Temporary Suspensions

The number of informal settlement conferences and mediations both decreased in FY 2023. There were 13 informal conferences, 99 mediations, and 34 hearings with the State Office of Administrative Hearings in FY 2023.

III. Licensing Highlights

Continued Growth in Professional Nursing –

Continued Decline in New Licenses for Vocational Nurses

Texas continues to have a substantial growth in the numbers of licensed Advanced Practice Registered Nurses with newly issued licenses growing 14.4% from FY 2022 to FY 2023. Likewise, the total number of Registered Nurses continues to grow from both examination and endorsement from other US jurisdictions increasing 5.7% from FY 2022 to FY 2023.

A continued trend from the previous fiscal years is the overall decline in the number of currently Licensed Vocational Nurses. From FY 2022 to FY 2023 there has been a 0.5% decrease in the total number of LVNs holding a current license in Texas. From FY 2022 to FY 2023 the overall population of Texas licensed nurses increased by 5.2%.

Of note is the continued drastic increase of applications for initial licensure by examination by international applicants. After a drop of international applications during the height of the pandemic in FY 2021 due to international testing centers closures, the number of applications increased by approximately 300% from FY 2022 to FY 2023.

The Texas Nurse Portal continues to allow the Board to transition from a paper-based licensing system to a completely paperless system. The Texas Nurse Portal is a confidential and secure system that allows applicants to apply online for nurse licensure by examination, endorsement, or renewal. The impact of this new system has greatly increased the efficiency of the licensing process for both constituents and staff. The agency continues to refine internal processes and update licensing software which enables staff to be more efficient.

As of September 1, 2022, the Board no longer accepts paper license verification documents, letters of employment and affidavits of graduation. Now the Board requires digital documents to be sent from primary sources electronically. The Board’s outreach efforts to notify all stakeholders of this change remains constant and ongoing.

The Board relocated to the George H. W. Bush State Office Building located at 1801 Congress Avenue at the end of FY 2022 (August 2022). In preparation for the move, the agency focused efforts on records retention to minimize the volume of paper required to be moved. As the agency continues to strive toward more paperless operations and increased reliance on electronic documentation and communication, the need for information technology expertise has increased which will impact future agency budget requests.

IV. Nursing Education Highlights

Nursing Education and the Nursing Shortage in Texas

The 2022 National Nursing Workforce Study provided data on the state of the nursing workforce for the first time since the onset of the pandemic. The study revealed that approximately 100,000 registered nurses and 34,000 licensed practical and vocational nurses left the workforce over the past two years as a result of the pandemic. The study predicts that 800,000 RNs and 184,000 LPNs/ LVNs are likely to leave nursing by 2027. That is equivalent to roughly 20% of the total licensed RN and LPN/LVN workforces in the U.S. (NCSBN, 2022).

During FY 2023, the Board continued to receive letters of intent from parties planning to seek approval to offer new nursing education programs. The Board approved four new nursing education programs in FY 2023.

The Board’s education consultants continued to work closely with education programs to foster and support creative solutions to the persistent challenges of restricted clinical learning settings.

In March 2022, Texas Workforce Commission (TWC) began an initiative to classify nursing as an apprenticeable occupation to allow U.S. Department of Labor (DOL) funds to be applied to nursing education in Texas. Approval by DOL allows healthcare agencies and professional nursing education programs to apply for DOL apprenticeship funding. During FY 2023 the Board approved one VN apprenticeship program, allowing this program to obtain DOL funding after their curriculum track was approved.

FY 2023 saw funding increases for nursing education. The Texas Higher Education Coordinating Board (THECB) administers the Nursing Shortage Reduction Program, the Nursing Faculty Loan Repayment Program, and the Nursing Innovation Grant Program, all designed to increase the supply of registered nurses in Texas. The 88th Texas Legislature, Regular Session, appropriated $23,400,000 to the THECB for the Professional Nursing Shortage Reduction Program and $12,500,000 for nursing scholarships. Additionally, $6,000,000 was appropriated for the Nursing Innovation Grant Program (NIGP). The NIGP provides grants to higher education institutions to promote the education, recruitment, and retention of nursing students and qualified faculty. The awards are intended to aid those programs developing innovative solutions to increase nursing preceptors and simulation

coordinators, thus working to ease the shortage of nursing faculty.

NCLEX® Examination Pass Rates in Texas & Next Generation NCLEX® Rollout

In April 2023 a new NCLEX® was launched as a result of a multiphase research project conducted by the National Council of State Boards of Nursing. These new Next Generation NCLEX®(NGN) items are designed to measure the complex clinical judgments nurses must be able to make in order to provide safe and effective patient care. A Clinical Judgment Measurement Model (CJMM) was designed based upon leading theories of decision making (information processing; intuitive/ humanistic; and cognitive continuum). The CJMM depicts a nursing decision making model involving recognizing and analyzing cues, prioritizing hypotheses, generating solutions, taking action, and evaluating outcomes. Board Staff have provided education programs with regular updates since the project inception in 2017 to allow programs to make any necessary curricular adjustments prior to the NGN launch. As of November 27th, 2023, the preliminary NCLEX pass rates for Texas programs were 92.89% for the NCLEX-PN and 91.01% for the NCLEX-RN. In April 2024, the Board will review the final results of the first year of the NGN.

Standardized Exams

During the 88th Texas Legislative Session, Senate Bill 1429 relating to the use of standardized examinations by a school of nursing or educational program passed. The bill prohibits the use of a standardized examination as a graduation requirement or to deny students an affidavit of graduation. The bill also includes ways in which standardized examinations may be used that are consistent with the Board of Nursing 2017 Education Guideline 3.7.4.a. The Use of Standardized Examinations in Nursing Education Programs

Key points of the bill include:

• If standardized examination scores account for part of a course grade, those scores must not account for more than 10% of that course grade.

• When it is decided that students need remediation based upon a standardized exam score, the school may not require the student to attend a course offered by the

exam provider (vendor) nor simply switch to another vendor.

• The program should provide faculty-developed/guided remediation.

• Compliance with the law is required for ongoing program approval.

Nursing Consultants for Education have been working diligently with nursing education programs to disseminate Frequently Asked Questions, clarify intent of the law, and provide feedback on compliance with the law.

Operation Nightingale and Out-of-State Nursing Education Programs

On January 25, 2023, the U.S. Department of Health and Human Services Office of Inspector General (HHSOIG) and law enforcement partners launched a multistate coordinated law enforcement action to apprehend individuals engaged in a scheme to sell false and fraudulent nursing degree diplomas and transcripts. The alleged scheme involved the selling of fake and fraudulent nursing degree diplomas and transcripts obtained from accredited Florida-based nursing schools to Registered Nurse (RN) and Licensed Practical/Vocational Nurse (LPN/VN) candidates.

The individuals who acquired the fraudulent nursing credentials used them to qualify to sit for the national nursing board exam. Upon successful completion of the board exam, the nursing applicants became eligible to obtain licensure in various states to work as an RN or a LPN/VN.

Upon being notified of Operation Nightingale and provided the lists of schools and individuals involved in the federal investigation, Board staff began working

with affected stakeholders including boards of nursing, nursing education program faculty, accreditors and federal authorities to detect, investigate and resolve these matters as quickly as possible. A webpage was created on the Board’s website to share information regarding the schools involved in the scheme, press releases, licensees with formal charges and disciplinary actions, and licensure denials.

In addition to Operation Nightingale, throughout FY 2023, Board staff continued to receive exam and endorsement LVN and RN licensure applications from graduates of out-of-state nursing education programs, many of whose approval status has been revoked due to low NCLEX® pass rates, or if still approved by another board of nursing having extremely low NCLEX® pass rates. Licensing and education staff continued to implement a review process initiated in FY 2021 to ensure that these applicants were educated by a program that is substantively equivalent to programs approved in Texas. The workload of licensing, enforcement, legal and education staff has increased significantly as a result. Therefore two nurse educators were hired by contract to assist in the educational reviews. To address this workload, additional staff positions, including a Nursing Consultant for Education, were created utilizing the regulatory response rider biennium funding provided to the agency by the legislature for Operation Nightingale.

V. Nursing Practice Highlights

Advanced Practice Registered Nurse Scope of Practice Rule

Amendments and Guidance Documents

On January 5, 2023, the Advanced Practice Nursing Advisory Committee (APNAC) re-convened to review public comments received from stakeholders and provide recommendations to the Board. At the January 19, 2023, quarterly meeting, the Board reviewed the recommendations provided by APNAC and adopted Board Rule 221.12, relating to scope of practice for Advanced Practice Registered Nurses (APRNs). APNAC met again on December 15, 2023, to review scope of practice guidance documents developed by staff. The finalized guidance documents will be presented to the Board at the January 2024 Board meeting. Once approved, Staff will disseminate the guidance documents and education relating to APRN scope of practice to APRN stakeholders.

Support for the Texas Prescription Monitoring Program

The Texas Prescription Monitoring Program (PMP), managed by the Texas State Board of Pharmacy (TSBP), collects and monitors outpatient prescription data for all Schedule II, III, IV and V controlled substances dispensed by a pharmacy in Texas. The primary intent of the PMP is to prevent prescription drug misuse, diversion and overdose. As of March 1, 2020, Texas prescribers, including those advanced practice registered nurses (APRNs with prescriptive authority who prescribe controlled substances) and pharmacists are required by law to check the PMP for every patient, every time, before prescribing or dispensing opioids, benzodiazepines, barbiturates, or carisoprodol. TSBP announced in August 2023, statewide support to help healthcare providers integrate PMP data and NarxCare analytics into approved Electronic Health Records (EHR) and Pharmacy Management System (PMS), using Bamboo Health’s PMP Gateway solution. TSBP began funding the licensing fees associated with the integration service for providers in Texas that elect to connect their EHR or PMS to PMP Gateway effective Sept. 1, 2023. The Board of Nursing provides funding for the PMP based upon the population of APRNs with prescriptive authority in Texas. As a member agency of the Interagency Prescription Monitoring Workgroup, which was created to evaluate the effectiveness of the PMP monitoring and offer recommendations for its improvement, the Board of Nursing supports the Pharmacy Board’s request for additional appropriations

to enhance the Texas PMP through the addition of NarxCare and Statewide Integration. These two software solutions will improve the PMP and allow for better and easier monitoring, patient care and safety.

Consultative Functions

In addition to its education outreach functions, the practice team also consulted frequently with the enforcement and legal teams on disciplinary matters related to nursingpractice violations.

Consultants assisted with case reviews, many mediations, and served as expert witnesses during virtual hearings before the State Office of Administrative Hearings. This type of consultative work is highly detailed and time intensive. Consultants also participated in informal conference hearings and Eligibility and Discipline Committee meetings. This role remained active during FY 2023 as mediations and formal hearings continued. Additionally, staff continued consultation with stakeholders to stay abreast of new trends in nursing practice. Staff will monitor these trends to determine if the agency will need to request additional staff in the 2025 legislative session.

Education Offerings for Nurses

The practice team continued to offer nursing jurisprudence and ethics workshops virtually as well as one face-to-face offering in June of 2023. The turnout for the in-person offering was small as participants continue to reinforce their preference for virtual offerings as they provide a practical and accessible method to obtain continuing nursing education and meet board order educational requirements. The practice team will continue with virtual delivery of the workshop in 2024, with one faceto-face offering to meet the needs of those that prefer an in-person workshop. The team continued to develop and update a collection of online courses on additional topics including documentation, nursing peer review, APRN scope of practice, and APRN prescriptive authority throughout FY 2023.

NOTICE OF DISCIPLINARY ACTION

The following nurses had disciplinary action taken against their licenses through a Board order containing public information about the nurse’s disciplinary action. While every effort is made to ensure the accuracy of this information, the Board's licensure verification system should be utilized for verification. You can obtain information about these disciplinary actions from the Board’s website, www.bon.texas.gov, using the verification look-up under Licensure or under the disciplinary action section of Discipline & Complaints. Under Licensure, select Verification, then click on the applicable license type; Discipline & Complaints, select Disciplinary Action, then select individual newsletter date. Additionally, you can send your written request to the Texas Board of Nursing, Enforcement Division, 1801 Congress Avenue, Suite 10-200, Austin, Texas 78701.

Abdou, Ahlam Elwan RN 810475

Aguilar, Nereyda LVN 1069907

Arledge, Margoletta

Lashawn LVN 170111

Attaway, Kiara Monique LVN 350440

Avila, Anna Christine RN 929816

Babale, Hajara

Bailey, Sally Lee RN 453883

Barlow, Toni Michele RN 699403

Barnhill, Cathy Jo RN 596921

Barrett, Trisha Nichole LVN 211606

Belch, Rebecca Jo

Besson, Danna Gay

Blair, Jennifer Jo RN 629818

Border, Kristyn Denise

Cain, Ruthie M. RN 628682

Calamaco (Molina), Valeria LVN 304762

Campbell, Michelle G. RN 739423

Castaneda, Peter James LVN 153943

Voluntary Surrender 1/4/24

Warning with Stipulations and Fine 1/25/24

Castillo, Rodan Araza RN 1088542 Reprimand with Stipulations 11/14/23

Cavet, Jennifer Rose LVN 340053

Chambers, Susan Lynn RN 767054

Charles, Marie Alvina LVN 70121

Clairvil, Frederique PTP FL RN9287471

Cobb, Charlotte Elizabeth RN 991019

Cooper, Jennifer Laurie AP108813, RX 2791 & RN 608062

Cooper, Lorraine C. RN 657051

Coulter, Celina Melissa LVN 147592

Cox, Stephanie Zamor RN 838659

Coy, Todd Anthony RN 961574

Craft, Jennifer Lynn LVN 1021775

Cruz, Joseph Zackary RN 835818 & LVN 225491

Culberson, Crystal Morris LVN 335288

Cullins, Angela Denise LVN 160382

Cunningham, Tiffeny RN 1064181

Dacus, Nicole Leeann RN 873636

Davilamata, Gisela Yazmin RN 1034505 & LVN 327385

Davis, Liesha Shawn RN 654534

Deleon, Cathy Lee RN 701329 & LVN 174313

Denham, Janice Hale RN 582683

Remedial Education 12/8/23

Warning with Stipulations 1/25/24

Probated Suspension 12/12/23

Remedial Education with Fine 11/17/23

Probated Suspension 1/25/24

Warning with Stipulations

Deferred 1/25/24

Voluntary Surrender 12/4/23

Revoked 1/25/24

Warning with Stipulations and Fine 1/25/24

Warning with Stipulations 12/12/23

Remedial Education with Fine 11/14/23

Probated Suspension 11/14/23

Reprimand with Stipulations 1/25/24

Warning with Stipulations and Fine 12/12/23

Warning with Stipulations 11/14/23

Warning with Stipulations 12/12/23

Remedial Education with Fine 1/9/24

Remedial Education with Fine 12/20/23

Remedial Education 11/30/23

Warning with Stipulations 11/14/23

Diaz Jr., David LVN 348986 Remedial Education 12/15/23

Dix, Marva Lyn RN 539286

Djuipa, Sylvanie Feutsi RN 1013347

Doughty, April L. RN 256205

Ellinger, Megan Rae LVN 334884

English, Lacey Dianne LVN 328756

Warning with Stipulations 11/14/23

Remedial Education 1/9/24

Probated Suspension 12/12/23

Warning with Stipulations and Fine 12/12/23

Probated Suspension 12/12/23

Eseny,

Espinoza,

Falzerano, Taylor Deann LVN 1035683

Fholer, Nancy Anne

Hausser RN 512847

Finn, Rachel Ann LVN 164213 Warning with

Flournoy, Ashley Danielle RN 1013872 Warning with

Fortenberry, Schwanna Lynette AP133308, RX 22522 & RN 713940 Probated Suspension

Fowler, Jessica RN 967192 & LVN 327692

Freeman, Rashida Oleta LVN 311314 Warning with Stipulations

Frieman, Jodell Ruth RN 538078 & LVN 93148

Fry, Judy Ann LVN 1085479 Probated Suspension 11/14/23

Fuentes, Tracy Lynn LVN 329811

Garcia, Rachel Ann Bird LVN 317046

Warning with Stipulations 11/14/23

Warning with Stipulations 11/14/23

Gaskie, Keith Allen RN 821309 Reprimand with Stipulations 11/14/23

Gaytan, Jessica Yvonne LVN 326050 Reprimand with Stipulations 12/12/23

Gerardo, Amanda RN 912126

Gibson, Kristin Kay RN 877592

Gonzales, Desireah RN 827913

Gonzalez, Kiyga Lashone RN 803892 & LVN 206314

Graniella, Linda RN 729068

Gray, Kathryn Nicole AP120501, RX 11435 & RN 717114

Green, Linda F. RN 521892

Greer, Amberly Danielle LVN 222056

Gressett, Andrea Page RN 925082

Griego, Annette AP116330 & RN 673172

Grimmer, Ruth Ann Gerhart RN 658467

Guy, Melissa Ann LVN 1049853

Hall, Keegan Kathleen RN 990225 & LVN 348655

Happ, Jessica RN 1103975 & LVN 334324

Hinton, Kalvin AP129980, RX 19603 & RN 1111080

Holliday, Allan RN 648246

Houtz, Stevi Dawn LVN 224846

Huett, Jay Alexander RN 751598

Hullum, Laura Ruthanne RN 844343

Humphrey, Kris Ann AP119706 & RN 523062

Hutson Sims, Amber Dawn LVN 232571

Hutton, Faith Lee LVN 188292

Ishaq, Solomon RN 911305

Jama, Abdulkadir M. LVN 351004

Johnson, Amy Elizabeth AP140211, RX 28931 & RN 829591

Johnson, Ginger RN 890638

Johnson, Kirby Donta LVN 219044

Warning with Stipulations 11/14/23

Warning with Stipulations 12/12/23

Remedial Education with Fine 1/2/24

Warning with Stipulations 1/25/24

Warning with Stipulations 12/12/23

Warning with Stipulations 11/14/23

Reprimand with Stipulations 12/12/23

Warning with Stipulations and Fine 11/14/23

Warning with Stipulations 1/25/24

Warning with Stipulations 1/25/24

Remedial Education 11/16/23

Warning with Stipulations 11/14/23

Reprimand with Stipulations 11/14/23

Warning with Stipulations 11/14/23

Voluntary Surrender 12/11/23

Limited License 1/11/24

Warning with Stipulations 12/12/23

Remedial Education with Fine 12/29/23

Remedial Education with Fine 1/9/24

Voluntary Surrender 12/18/23

Reprimand with Stipulations and Fine 11/14/23

Revoked 11/14/23

Remedial Education Deferred 12/20/23

Revoked 11/14/23

Remedial Education with Fine 11/10/23

Warning with Stipulations 12/12/23

Warning with Stipulations 11/14/23

continued on next page

DISCIPLINARY ACTION -

Johnson, Lucita F. RN 597738

Jones, Mary Udoh RN 897996 & LVN 213655 Probated Suspension 1/25/24

Jones, Nyreshia Cinque LVN 1050199 Reprimand with Stipulations 12/12/23

Jordan, Floyd Andrew RN 711726

Kelly, Kimberly Diane LVN 191594

King, Alecia Nicole PTP MS RN 897420

Voluntary Surrender 12/14/23

Revoked 12/12/23

Reprimand with Stipulations 12/12/23

Land, Kimberly Fitzgibbons RN 1085964 Warning with Stipulations 12/12/23

Laquindanum, Paul Paculan RN 1038757 Reprimand with Stipulations 1/25/24

Laster, Melanie Amber LVN 343861

Voluntary Surrender 1/12/24

Lee, April Lachell LVN 226515 Remedial Education with Fine 11/3/23

Lefrere, Soumia RN 802957 Enforced Suspension 1/12/24

Leija, Maricela Alvarez RN 989412 & LVN 324703 Voluntary Surrender 1/12/24

Leitch, Allison Marvel RN 589341

Warning with Stipulations 1/25/24

Letbetter, Kristen Danielle RN 849512 Reprimand with Stipulations 11/14/23

Lewis (Younger), Mary Elzabeth LVN 216973

Lopez, Alex RN 1008750

Lopez, Shaina Nicole LVN 213144

Lopez, Sylvia Ann RN 601453 & 52386

Luc-Wasik, Ewa Agata RN 635038

Malone, Levi Blu RN 938589

Warning with Stipulations 12/12/23

Remedial Education Deferred 11/9/23

Warning with Stipulations and Fine 11/14/23

Revoked 1/23/24

Enforced Suspension 12/12/23

Enforced Suspension 11/7/23

Mansfield, Pamela PTP WI RN 116131 Remedial Education 1/31/24

Marin, Michelle Marie LVN 329699 Remedial

Marks, Lesa Danielle LVN 177748 Revoked

Martin, Jessica R LVN 197055

Martinez, Kaija Jetaun RN 857456 & LVN 303966 Warning with Stipulations and Fine 1/25/24

Martinez, Rosa Emma RN 762843 & LVN 185649 Warning with Stipulations 11/14/23

Mbah Bikie, Florentine

RN 869307

McCleskey, Ashley Nichole LVN 309850 Voluntary Surrender 11/27/23

McCoy (Sirls), Veronica Roychelle AP113533 & RN 662441 Warning with

McCracken, Ty Christian RN 749929 Probated Suspension 12/12/23

McGee, Ashley Donte RN 926954 Warning with Stipulations 12/12/23

McKinnie, Thomas

Dewayne RN 1030462

McMannes, Robbin Lynn LVN 348602

Merkel, Karen Ann AP127465 & RN 703478 Remedial Education 1/19/24

Milner, Kimberly RN 973494

Mokua, Josiah RN 1043181 Voluntary Surrender 12/20/23

Moreno, Jose Fernando RN 675120 & LVN 147879 Voluntary Surrender 1/8/24

Morgan, Kenneth Eugene LVN 194641 Probated Suspension 11/14/23

Moses, Kathy Marie RN 647760

Moses, Stacey Alyiss RN 932740 & LVN 326051

Mujica, Ariana LVN 351694

Munn, Kristi Marie LVN 348747

Munoz, Rhonda Kaye AP140059, RX 28815 & RN 714492

Murphy, Monica Perry RN 720815

Murray, Michelle Elizabeth LVN 216347

Ng, Clara L. RN 771285

Nizigiyimana, Seconde RN 1034506

Ogbeh, Winifred Nneka LVN 343044 Reprimand with Stipulations 12/12/23

Ogbojo, Ogheneovo Mary LVN 175348 Probated Suspension 12/12/23

Ogegere, Cheryl Brown LVN 326126 Warning with Stipulations 11/14/23

Okere, Nelly AP132623 & RN 606821 Warning with Stipulations 11/14/23

Owens, Jacob Warren RN 792068

Patrick, John Ward RN 678927 & LVN 139585 Probated Suspension 1/25/24

Patterson, Pamela Dale LVN 175568

with Stipulations 12/12/23

Pena, Gabriela Bejarano LVN 347289 Probated Suspension 12/12/23

Perry, Kelia Denise LVN 218158 Enforced Suspension 1/25/24

Person, Deborah Ann LVN 158734 Reprimand with Stipulations 12/12/23

Pherigo, Devan Kaye LVN 315413 Revoked 12/12/23

Piper, Sentura Delaine LVN 165575 Probated Suspension 11/14/23

Pool, Desire RN 991079 Revoked 1/25/24

Pourabedini, Alireza RN 865209 & PTP IN RN 28235830A Warning with Stipulations 11/14/23

Purswell, Louis Paul RN 742014 Warning 11/14/23

Pyle, Lela Renee RN 776426 & LVN 163060

with Stipulations and Fine 12/12/23

Rainey, Dawn Woods LVN 207947 Warning with Stipulations and Fine 1/25/24

Ramirez, Angela J. RN 1057559

Rees, Ashleigh Rene RN 1015016

Richards, Patrice PTP GA RN 227252 Warning with Stipulations 1/25/24

Rocha, Micaela Elizabeth RN 1061601 Remedial Education with Fine 1/23/24

Rosare, Suri PTP WI RN 221780

Salinas, Michael Anthony LVN 154981

Samluk, Thomas James RN 1069286

Jamyra E. LVN 1069971

Sangolana, Michael Adekitan RN 772297

Sappayani, Julhajir Arjan RN 664894

Sauke, Kimberly A. RN 522639

with Stipulations 1/25/24

Scholz, Susan Elizabeth AP106140 & RN 566966 Probated Suspension 1/25/24

Scott-Robinson, Laura Monnise LVN 1053410

Scruggs, Chauncey Dante LVN 331604

Shin, Jae Ok RN 559368

Shoecraft, Kristena Michelle LVN 333772

Simmons, Alyssa Lynn RN 1040323

Revoked 1/25/24

Warning with Stipulations 11/14/23

Remedial Education 1/5/24

Warning with Stipulations 11/14/23

Warning with Stipulations 11/14/23

Probated Suspension 12/12/23

Warning with Stipulations and Fine 12/12/23

Warning with Stipulations

Deferred 11/14/23

Voluntary Surrender 12/27/23

with Stipulations 11/14/23

Warning with Stipulations 12/12/23

Warning with Stipulations 1/25/24

Simmons, Julie Dawn RN 665193 Reprimand with Stipulations 1/25/24

Smith, Dylon Terry LVN 350476 Revoked 1/25/24

Smith, Ezekiel Ty RN 924728 Revoked 1/25/24

Smith, Lesslie Diane RN 953077 Reprimand with Stipulations 11/14/23

Sosa, Gina M. LVN 182758 Enforced Suspension 11/29/23

Steen, Patrice Monick LVN 210475

Warning with Stipulations and Fine 1/25/24

Stickels, Jaelin AP126970 & RN 789362 Remedial Education 11/16/23

Tabada, Arlo Weesit RN 760327 Reprimand with Stipulations 1/25/24

Tannos, Linda Gail RN 920117

Tebby, Merrin Dawn RN 772216

Tellez, Sandra Jean RN 970436

Towouh, Fanta Judith LVN 344515 Warning with Stipulations 1/25/24

Trader, Glenda Faye RN 1027100

Uwa, Gladys

Vanstory,

Vickery, Stacey Denise RN 751040

Walton, Donna Kay LVN 166274

Warford, Erica LVN 300444

Washington, Samantha S. RN 1027007

Webb, Kenneth AP113712, RN 651864 & LVN 159518

Welsh, Nikki Marie RN 845728

Wendenburg, Barbara Berry RN 500995 &

Wilcox, Eraida RN 777212 &

Williams, Glenisha Marie RN 986210

Willis, Leon LVN 158166

Wilson, Amanda Renee RN 680145

80509

with Fine

Wright, Summer LeeDaniel LVN 306428 Revoked 11/14/23

Yared, Marian Philip AP139682, RX 28450 & RN 879612

Warning with Stipulations 12/12/23

Yoder, Hannah Marie RN 856639 Warning with Stipulations 11/14/23

PTP Privilege to Practice in Texas associated with the indicated state and license.

RX Prescription Authorization

Statistical information

The 201 disciplinary actions reported in this bulletin represent only 0.039% of nurses who are currently licensed to practice in the State of Texas.

As of February 29, 2024, 99.74% of current Registered Nurses, 99.40% of current Licensed Vocational Nurses, and 99.73% of current Advanced Practice Registered Nurses were without discipline according to Board records.

Scam Alert – Beware of Scammers Using Fake Letterhead, Phone Numbers, and Investigator Identities

Scammers attempting to manipulate or defraud nurses continue to change their tactics in order to swindle nurses. Recently, an Advance Practice Registered Nurse (APRN) was contacted by a scammer who stated he was an investigator working for the Texas Board of Nursing (BON or Board). The phone number on the nurse’s Caller ID was the main number (512) 305-7400. Changing the Caller ID phone number appearing on the phone is one of the oldest and easiest scams utilized by scammers. The scammer stated that they were an investigator for the Board and offered their name and badge number (BON investigators do not have badge numbers) to the nurse before telling the nurse that they were suspected of crimes including drug trafficking and money laundering. The scammer persuaded the APRN to travel to a location where they could receive a fax document from the scammer that would confirm what the scammer was saying. The nurse received the fax document, which was fake and included phony signatures. The document appeared to be BON letterhead, which the scammer had prepared using old graphics from the website together with fake signatures for the Investigator and the Executive Director. The letter stated that the APRN’s license had been suspended. The scammer attempted to use the suspension fax document to coerce the nurse to take further action. The APRN wisely contacted the Board and determined that their license was not suspended and they had been the target of a scam attempt.

Scammers will attempt to gain the confidence of the intended victim to either request money to “pause” an investigation or take some other type of action which benefits the scammer. The BON does not notify nurses by Fax that their license has been suspended. Nurses are contacted by certified mail if they are under investigation. A hearing is conducted in advance of action by the Board and the nurse would receive notifications by mail concerning the hearing. Scammers do not want nurses to independently contact the Board to verify the information they have provided. If you are contacted by phone by an individual claiming to work for the Board and they are alleging that actions have been taken under your license number and name and further action by you is requested, contact the BON directly to confirm the information provided.

Nurses contacted by such an individual should:

Report the attempted fraud to the Office of the Inspector General (OIG) for the U.S. Department of Health and Human Services. For more information, go to https://oig.hhs.gov/fraud/report-fraud/index.asp, and

Contact the Office of Consumer Protection (OCP) for the Attorney General of Texas. Visit https://www.texasattorneygeneral.gov/consumer-protection/phone-mail-and-fax-scams/how-spot-and-report-phone-scams for more information on phone scams and to file an Online Consumer Complaint.

Upcoming TPAPN Educational Opportunities

The Texas Peer Assistance Program for Nurses (TPAPN) safeguards patients by providing early identification, support, monitoring, accountability, and advocacy to Texas nurses who have an identified substance use or mental health condition or related incident, so they may practice nursing safely. The TPAPN website (www.tpapn.org) has more information about the TPAPN program.

The Peer Support Partner is a volunteer nurse who provides peer support, guidance, encouragement, and more, to nurses participating in TPAPN. The group is looking for more Peer Support Partners. Peer Support Partner Information Sessions are provided by TPAPN staff so interested nurses can learn more about the fundamental role of the Peer Support Partner. Please visit the TPAPN webpage (www. tpapn.org) for information about upcoming events to find dates for the next available TPAPN Peer Support Partner Information Session and other training opportunities.

TPAPN has launched on-demand information sessions about the TPAPN program (and training for new and current peer support partners). The online information session (TPAPN Program Overview) & modules on Addiction, Mental Health Conditions, Motivational Interviewing, & Person-Centered Care are accessible by following the directions below:

1. Go To https://www.texasnurses.org/

2. Go to the Professional Development tab and click Get CNE

3. Go to Categories and select TPAPN On Demand, where you will see a list of available options.

4. Select Register, if you are not a TNA member, you can create a non-member account to login

5. Watch the course, then get your certificate. A nurse may self-refer to TPAPN, an employer may refer a nurse to TPAPN, or the Board may refer or order a nurse to TPAPN. A nurse with a substance use or mental health condition that might impact nursing practice is encouraged to self-refer to TPAPN prior to the condition impacting nursing practice. An employer may refer a nurse to TPAPN if the condition has not impacted nursing practice; however, the employer is required to report the nurse to the Board of Nursing (BON) if there has been a nursing practice violation. The TPAPN referral form is on the TPAPN website. The BON website contains links to file a complaint online under Discipline & Complaints – How to File a Complaint.

Summary of

Actions - cont. from page 3

§301.151.

In the March 15, 2024, edition of the Texas Register, the Board adopted new 22 TAC §213.36 and §213.37. The Board simultaneously proposed both new sections in the December 22, 2023, issue of the Texas Register (48 TexReg 7740). The adopted rule text of 22 TAC §213.36 contains a change which resulted in republication of this section. There were no changes to the proposed text of 22 TAC §213.37. During the 88th Legislative Session, the Texas Legislature enacted Senate Bill (S.B.) 1343 which requires that complaints alleging a standard-of-care violation by an Advanced Practice Registered Nurse (APRN) be reviewed by an expert reviewer, appointed by the Board, who is an APRN practicing in the same advanced practice role and with the same population focus as the APRN who is the subject of the complaint. The bill further requires that the appointed expert reviewer determine whether the APRN violated the standardof-care applicable to the circumstances of the allegation, record the expert reviewer’s conclusions in a report, and submit the report to the Board. Before initiating informal proceedings involving the APRN, the Board must provide notice of the proceedings along with a deidentified copy of the expert reviewer’s report. These new sections were adopted for compliance with the statutory mandates found in TOC §§ 301.457, 301.4575, and 301.464.

The Board also adopted new 22 TAC §214.14 and new 22 TAC §215.14, relating to Standardized Examination Prepared by Private Entity, without changes to the proposed text published in the December 22, 2023, issue of the Texas Register (48 TexReg 7742). During the 88th Legislative Session, the Texas Legislature enacted S.B. 1429, which required the BON to

adopt rules related to the use of a standardized examination prepared by a private entity. The rules must be applicable to all schools of nursing regulated by the Board. S.B. 1429 requires that the rules prohibit the use of a standardized examination as a graduation requirement or to deny students an affidavit of graduation. The required rules authorize the use of standardized examination only to familiarize students with computerized testing and for the enumerated and limited purposes in TOC § 301.1571(a)(2)&(3). S.B. 1429 further requires that a standardized examination, prepared by a private entity, may not account for more than ten (10) percent of a course grade. Additionally, S.B. 1429 requires that the adopted rules prohibit the regulated school from requiring a student to attend a course offered by the private entity which provides the standardized examination. The rules adopted by the Board are necessary to implement this legislation.

The BON, also in the March 15, 2024, edition of the Texas Register, adopted amendments to 22 TAC §217.5, relating to Temporary License and Endorsement, with changes to the proposed text published in the December 15, 2023, issue of the Texas Register (48 TexReg 7286). In 2019, the Texas Legislature enacted S.B. 1200 which created TOC § 55.0041, to recognize out-of-state occupational licenses for a spouse of a military service member. This allows the portability of a license for the spouse of a service member, so the spouse does not have to redo any curriculum and testing from one state to another when the service member changes duty station.

In 2021, during the 87th Regular Legislative Session, the Legislature enacted House Bill (H.B.) 139 that further amended TOC § 55.0041, requiring a state agency that issues

a license with a residency requirement for license eligibility to adopt rules regarding the documentation necessary for a military spouse applicant to establish residency; allowing the provision to the agency a copy of the permanent change of station order for the military service member to whom the spouse is married.

During the 88th Legislative Session, S.B. 422 was enacted, which amending TOC § 55.0041 extending this occupational licensing reciprocity to military members themselves who often must station in states outside of their original license was issued, but who still wish to provide valuable services, such as nursing, that are experiencing workforce shortages. Under the new bill, a state agency that issues business or occupational license must determine within a thirty-day period whether the original jurisdiction of licensure for a military service member or military spouse is in good standing. Upon confirmation, a military service member can retain the Texas license for three years. The revised law also provides that a military spouse licensed pursuant to TOC § 55.0041, may retain the license for the full three-year period notwithstanding a divorce or similar event affecting the license holder’s status as a spouse. The adopted amendments are necessary to comply with these statutory changes.

The effective dates for new 22 TAC §213.36, §213.37, §214.14, §215.14, and amended §217.5 was March 21, 2024.

Information published in the Texas Board of Nursing Bulletin is not copyrighted and may be reproduced. The Board would appreciate credit for the material used and a copy of the reprint. Please direct questions or comments to: Newsletter, Texas Board of Nursing, 1801 Congress Avenue, Suite 10-200, Austin, Texas 78701-3944. Comments may be emailed to bruce. holter@bon.texas.gov or call (512) 305-6842.

Office Hours and Location

The office of the Texas Board of Nursing is located in the George H.W. Bush Building, located next to the Bob Bullock Museum in downtown Austin, across the street from the University of Texas. The mailing address is: 1801 Congress Avenue, Suite 10-200, Austin, Texas 78701. Office hours are 8:00 a.m. to 5:00 p.m., Monday through Friday, except for designated holidays. If you need to reach the Board, please call (512) 305-7400 or send an email to: webmaster@bon.texas.gov

The Texas Board of Nursing is an equal opportunity/affirmative action employer and does not discriminate on the basis of race, color, religion, sex, national origin, age, or disability in employment or in the provision of services, programs, or activities.

The Texas Board of Nursing Bulletin is published quarterly by the Texas Board of Nursing. In compliance with the Americans with Disabilities Act, this document may be requested in alternate formats by contacting the Board's office, (512) 305-7400 (Voice), (512) 305-7401 (FAX), or by visiting the George H.W. Bush Building, 1801 Congress Avenue, Suite 10-200, Austin, Texas 78701.

Texas Board of Nursing Meeting Schedule

2024 Board Meeting Dates

April 18-19 July 18-19

October 24-25

2024 Eligibility and Disciplinary Committee Meeting Dates

May 14 June 11

August 13

November 12

September 10

December 10

For meeting times and locations, visit the Board of Nursing website.

* - The Board meeting scheduled for April 18-19, 2024, may be streamed online. Meeting access infomation will be posted at: www.bon.texas.gov

Board of Nursing Contact Information

MAIN NUMBER...........................................................(512) 305-7400

FAX.............................................................................(512) 305-7401

-- 24-hour Access

-- License Verification

-- General Information

ENFORCEMENT............................................................(512) 305-6838

-- Complaint and Disciplinary Action Inquiries

-- Violations of NPA and Rules and Regulations

-- Monitoring of Disciplined RNs and LVNs

CUSTOMER SERVICE..............................................(512) 305-6809

-- License Renewals, Endorsement, Examination, or Continuing Education for Nurses...........Licensing@bon.texas.gov

PROFESSIONAL AND VOCATIONAL NURSING

ADVANCED PRACTICE............................................(512) 305-6843

-- APRN Application and Prescriptive Authority Procedures....................aprn@bon.texas.gov

NURSING EDUCATION...........................................(512) 305-6816

NURSING PRACTICE...............................................(512) 305-6802

-- Nursing Practice Issues

-- Legislation

Nursys is the only national database for verification of nurse licensure, discipline and practice privileges for RNs, LPN/VNs, and APRNs licensed in participating jurisdictions, including all states in the Nurse Licensure Compact (NLC). There are three Nursys services publicly available via External Link nursys.com:

* e-Notify

* Nurse License Verification

* Licensure QuickConfirm