TEXAS BOARD OF NURSING
VOLUME LIV - No. IV
October 2023
BULLETIN
In this Issue: Summary of 88th Texas Legislative Session
Governor Abbott Appoints Four Members to Board of Nursing On August 10, 2023, Governor Greg Abbott appointed Kathy Boswell, MS, RN, and reappointed Mazie Mathews Jamison, BA, MA, and Verna "Kathy" Shipp, MSN, APRN, FNP, to the Texas Board of Nursing (BON or Board) for terms to expire on January 31, 2029. Kathy Boswell of Mineral Wells (not pictured) is the Dean of Health and Human Sciences for Weatherford College, where she founded the college’s associate degree in nursing program in 2000. She is a member of the Texas Association of Deans and Directors of Professional Nursing Programs and Texas Association of Vocational Nurse Educators and a former member of the American Nurses Association. Additionally, she volunteers as the chairwoman of the City of Mineral Wells Parks and Recreation Board and for the American Red Cross Youth Swim Program. Ms. Boswell received a Bachelor of Science in Nursing and a Master of Science from Texas Woman’s University.
The Texas Board of Nursing BOARD MEMBERS Officers Kathy Shipp, MSN, APRN, FNP President, representing Advanced Practice Nursing Lubbock
Kathy Shipp, MSN, APRN, FNP
Allison Porter-Edwards, DrPH, MS, RN, CNE, FAAN Vice-President, representing BSN Education Bellaire
Members Kathy Boswell, MS, RN representing ADN Education Mineral Wells
Mazie Mathews Jamison of Dallas retired as chief public policy officer of Children’s Medical Center in North Texas. Previously, she served as director of public policy for the Kaiser Foundation Health Plan. She is past chair of the Dallas Area Legislative Coalition and co-chair of the Leadership Dallas Alumni Association Social Committee. She has served as an executive committee member on the North Dallas Chamber of Commerce, member of the Kilgore College Foundation Board of Directors, and previous president and former board member of the Kilgore College Rangerettes Forever Board of Directors. Mazie received a Bachelor of Arts from The University of Texas at Austin and a Master of Arts from Texas State University. Ms. Jamison was first appointed to the BON on June 7, 2018.
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
Verna “Kathy” Shipp of Lubbock is a family nurse practitioner and on the faculty for the Family Nurse Practitioner Program at West Texas A&M University. She provides women’s health care for South Plains Public Health District clients. She is a member of the American, Texas, and South Plains Nurse Practitioner Associations and the American and Texas Nurse Associations. She is a member of the National Organization of Nurse Practitioner Faculty and the American Association of Colleges of Nursing. She represents Texas as a member of the National Council of State Boards of Nursing where she is Chair of the President’s Networking Group. She is a past member of the Sigma Theta Dru Riddle, PhD, APRN, CRNA Tau National Honor Society of Nursing and the Texas Health Disparities Task Force. Ms. Shipp received a Bachelor of Science in Nursing from West Texas State University, Master of Science in Nursing from The University of Texas at Austin, and a family nurse practitioner certificate from West Texas A&M University in Canyon. Ms. Shipp will continue serving as President of the Board. She was first appointed as President in 2012. On August 21, 2023, Governor Abbott appointed Dru Riddle PhD, DNP, CRNA, FAAN to the Board for a term set to expire on January 31, 2029, effective September 1, 2023. Dr. Riddle is an associate professor at Texas Christian University and teaches nurse anesthesia. He is also a clinically practicing nurse anesthetist in the Fort Worth community. He is the president of the American Association of Nurse Anesthesiology and a member of the Texas Association of Nurse Anesthetists, American Academy of Nursing, American Nurses Association, and the Texas Nurses Association. Additionally, he served as a member of the BON Advanced Practice Registered Nurse Advisory Committee. He is a former member of the Southern Nurses Research Society. Dr. Riddle received a Bachelor of Science in Nursing from Virginia Commonwealth University, a Master of Science in Nurse Anesthesia from Old Dominion University, a Doctor of Nursing Practice from Texas Christian University, and a Doctor of Philosophy in Nursing and Genetics from The Medical University of South Carolina. 2
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 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 LIV - No. IV Publication Office: 1801 Congress Avenue, Suite 10-200 Austin, Texas 78701-3944 Phone: (512) 305-7400 Fax: (512) 305-7401 Publication Date: 9/1/2023
Kristin K. Benton, DNP, RN, Selected as New Executive Director of Board of Nursing On July 20, 2023, the Texas Board of Nursing (BON or Board) announced the selection of Kristin K. Benton, DNP, RN, as Executive Director, effective September 1, 2023. Dr. Benton replaced Katherine A. Thomas, MN, RN, FAAN, who retired from her position as Executive Director on August 31, 2023, after serving as Executive Director since November 1995. Dr. Benton served as Director of Nursing for the Texas Board of Nursing from 2013 to 2023. In this role she led policy development and regulatory activities associated with pre-licensure nursing education, advanced practice registered nurse (APRN) licensure, and standards of nursing practice. Before joining Board staff, she taught in the Austin Community College Vocational Nursing Education Program from 2000-2012. In addition, she served on the Board representing vocational nursing education from 2008-2012 and was gubernatorially appointed as Board President
in 2011. Dr. Benton has also served on the Texas Center for Nursing Workforce Studies Task Force on Workplace Violence Against Nurses. Currently she serves on the National Council of State Boards of Nursing (NCSBN) Examination Committee and its International Center for Regulatory Scholarship Advisory Committee. She is a member of the Governor’s State Agency Council. Dr. Benton holds a Doctor of Nursing Practice (DNP) degree from Texas Tech University Health Sciences Center School of Nursing and was the recipient of the DNP Excellence in Nursing award in 2017. She has authored publications on nursing leadership, nursing regulation, and remediation of nursing practice breakdown. In 2022, she completed the NCSBN International Center for Regulatory Scholarship certificate program. The Board conducted a national search for Ms. Thomas’s replacement with an Executive Committee of five BON Board Members who conducted candidate interviews and made their recommendations for the primary and alternate candidates for the position to the full Board during Executive Session at the July 20, 2023, meeting of the Board of Nursing held at the Barbara Jordan Building in Austin, Texas.
Summary of Actions A regular meeting of the Board of Nursing was held July 20, 2023, in Austin. The following is a summary of Board actions taken during this meeting.
At the April 20, 2023, meeting of the Board of Nursing (BON or Board), amendments were approved to 22 Texas Administrative Code Chapter 214, relating to Vocational Nursing Education, and to 22 Texas Adminis-
trative Code Chapter 215, relating to Professional Nursing Education. The amendments correct outdated references, contain clarifying and editorial changes for better readability, and include a new reference system for
the Board’s educational guidelines for necessary flexibility. Proposed changes to Chapters 214 and 215 were published in the June 30, 2023, edition of the Texas Register.
Nursing Education Actions - July 2023 Board Meeting Reviewed Reports: 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 Report of Audit Review of Board-Approved Remedial Education Courses Approved Reports of Survey Findings: •
Cisco College in Abilene – Associate Degree Nursing (ADN)
and Vocational Nursing (VN) Programs • Tarleton State University in Stephenville – Bachelor of Science in Nursing Program Approved Notification of Closure of Programs: •
Central Texas College Military Track in Killeen – VN Program • Oxford Academy in San Antonio – VN Program Approved Proposal to Establish an Apprenticeship Track: 3
•
Vernon College in Vernon – VN Program Accepted Notification of Change in Administration: •
Army Practical Nurse Program in San Antonio – VN Program Approved Proposal to Establish a New Nursing Education Program: •
Texas School of Health Sciences in Weslaco – ADN Program
Katherine Thomas Retires After 27 Years as Executive Director at Board Katherine A. Thomas, MN, RN, FAAN, who retired from her position as Executive Director on August 31, 2023 served as Executive Director from November 1995 to August 2023. Ms. Thomas joined the Board in 1989 and served in several positions, including Interim Director of Education, Director of Practice and Compliance, and Director of Practice. During her time as Executive Director, Ms. Thomas guided the profession of nursing at the state and national level by assisting Texas in transitioning to use of the NCLEX Nurse Licensure Examination, transitioning Texas nurses to membership in the Nurse Licensure Compact which allows Texas nurses to practice in other states under compact licensure, implementing a paperless nurse licensure process, setting minimum competencies for newly graduated nurses, creating a single Board of Nursing in Texas, and adding criminal background checks for all Texas nurses. Ms. Thomas represented Texas nursing at the national level, serving in various positions at the NCSBN including President of the NCSBN Board, Director at Large, Representative to the Advanced Practice Registered Nurse (APRN) Joint Dialogue Group, Chair of the NCSBN Nursing Practice and Education Committee, and the NCSBN task force studying the Feasibility of Developing a Core Competency Examination for Nurse Practitioners. On October 15, 2011, Ms. Thomas was designated as Fellow to the American Academy of Nursing (AAN) at their 38th Annual Meeting and Conference held in Washington, DC. Ms. Thomas was honored with a resolution from Senator Lois Kolkhorst in August 2023. The Board wishes Ms. Thomas well in her future endeavors!
Allison Porter-Edwards Designated as Fellow to the American Academy of Nursing Allison Porter-Edwards, DrPH, MS, RN, CNE was designated as Fellow to the American Academy of Nursing (AAN) at their 50th Annual Meeting and Conference held in Washington, DC on October 7, 2023. Through a rigorous and competitive application process, the Academy’s Fellow Selection Committee, which is comprised of elected and appointed Fellows, reviewed nearly 400 applications, ultimately selecting the 2023 Fellows based on their contributions to advance the public’s health. Congratulations to Dr. Porter-Edwards on this prestigious honor! 4
Expiration of Continuing Education Requirement for Prescriptive Authority Texas has multiple targeted continuing education requirements for advanced practice registered nurses (APRNs) who hold prescriptive authority. One such requirement was the Prescription of Opioids requirement detailed in Board Rule 216.3(c)(5). As created by the Texas legislature in 2019, any APRN whose practice included the prescription of opioids was required to obtain at least one hour of continuing education annually covering the required content. This requirement was time limited and expired on August 31, 2023. For license renewals occurring after August 31, 2023, this requirement no longer applies. All other targeted continuing education requirements related to prescriptive authority remain in effect including: five additional contact hours of continuing education in pharmacotherapeutics [Board Rule 216.3(c)(3)], the Pain Management and Prescription of Opioids requirement detailed in Board Rule 216.3(c)(4), and required continuing education for nurses with authorization to receive information from the Texas Prescription Monitoring Program [Board Rule 216.3(c)(6)].
The Texas Center for Nursing Workforce Studies’ (TCNWS) 2023 Texas School Nurse Workforce Survey opened on October 1st and will close November 17th. The TCNWS is looking for individuals who are working in Texas as school nurses with Texas nursing licensure to complete this survey. Data provided will be instrumental in understanding the current and future needs of school nurses in Texas. Additionally, information in this survey will serve as a guide for the development of policy recommendations by the TCNWS Advisory Committee. The survey has been printed and will be mailed to 8,400 nurses that have identified their practice setting as “School Health Services” with the Board of Nursing. It is also possible to complete the survey online at https:// tcnws.co1.qualtrics.com/jfe/form/SV_2iCn7QYzvkEeRyC. Participation in this study is completely voluntary. Thank you school nurses!
Caller ID Spoofing Scam Alert Texas Board of Nursing (BON or Board) staff received a message from a nurse about a phone call they received where the Caller ID listed the caller as the Texas Board of Nursing and the phone number listed on the Caller ID was (512) 305-7400. The scammer stated that they were with the BON, verified the nurse’s first and last name, and license number. The scammer stated that there has been unusual activity on the nurse’s license, and the scammer needed to verify the unusual activity with the nurse. The nurse told the scammer that they would have to call the Board back to verify that the call was legitimate, then ended the call. The nurse later called the BON and determined that the call had been a scam and that their license had no “issues”. This type of Caller ID Spoofing is a very old scamming technique. It can be done from any phone system that can manipulate the outgoing Caller ID and there are millions of phone systems around the world where the Caller ID may be changed by the person making the call. When notified concerning this attempted scam, Board staff reported the call to the Texas Department of Information Resources (DIR). DIR investigated the call and determined that there was insufficient information to proceed with investigating the case since there are millions of phones whose sender Caller ID information can be changed by the user. The nurse who was contacted by the scammer made the correct choice, ended the call, and phoned the BON to confirm that the Board had not attempted to contact the nurse concerning some “unusual activity”. Nurses are encouraged to remain vigilant when suspicious call(s) are received and reach out to the BON independently if contacted in this manner. 5
Kudos to Texas Nursing Programs! The Next Generation National Council Licensure Examination (NCLEX) or NGN questions became operational on April 1, 2023! The move toward the changes in the NCLEX licensing exam originated in 2012 from national data indicating that new nurses, practicing nurses who work with new nurses, and nursing faculty validated that nurses at all educational levels are making important clinical nursing judgments as they begin practice. Beginning April 1, 2023, all licensed vocational nurse (LVN) and registered nurse (RN) candidates taking the NCLEX exam were given questions to measure their abilities to make correct patient assessments, plan nursing care to meet patient needs, and evaluate the effectiveness of that nursing care. Between 2012 and April 1, 2023, NCSBN and Pearson Vue staff were engaged in research in the development and analysis of new questions following a Clinical Judgment Measurement Model. Nursing programs have been emphasizing critical thinking, clinical judgment, and appropriate nursing interventions in readiness for the “NGN.” The table below indicates that students were prepared to apply their knowledge about patient assessment (cues) and analysis to provide and evaluate nursing care for the individual patient. There are three levels of NCLEX data: •
NCLEX pass rates for the quarter prior to the introduction of NGN.
•
NCLEX pass rates for the two quarters under NGN questions (April through September).
•
NCLEX pass rates for 2023 so far (lacking the final quarter of 2023). Type of Program
VN Programs
RN Programs
Before NGN
NCLEX with NGN
NCLEX for 2023
January 1- March 31, 2023
April 1-August 31, 2023
January 1-August 31, 2023
88.24%
96.17%
92.34%
(945/1071)
(1,104/1,148)
(2,049/2,219)
84.74%
94.72%
90.57%
(4,438/5,237)
(6,975/7,364)
(11,413/12,601)
Board Staff hypothesize that three factors may account for the increased pass rate: 1. Programs have recovered from the disruption of the pandemic. 2. Programs focused on higher level teaching strategies to encourage an improvement in clinical judgment. 3. The NGN questions are more realistic in reflecting patient care and nursing knowledge, more familiar to students. Individual NCLEX reports will be distributed to all vocational nursing and professional nursing programs in late January 2024 when all annual data will be downloaded and processed. These preliminary numbers are a positive indicator that NCLEX pass rates will be improved for 2023. 6
Legislative Summary: 88th Texas Legislative Session The following is a summary of bills relating to the practice of nursing in Texas reported on in the Legislative Report on the 88th Regular Texas Legislative Session at the July 2023 Board of Nursing (BON) Board Meeting. The full report can be viewed at: https://www.bon.texas.gov/pdfs/board_ meetings_pdfs/2023/July/1-3.pdf For the full text of the bills included in this summary, visit www. capitol.state.tx.us.
Bills Amending the Nursing Practice Act House Bill (HB) 2187 by Representative Yvonne Davis Relates to increased penalties for conviction for abandoning or endangering of elderly or disabled individuals. HB 2187 amends the Nursing Practice Act (NPA), Subchapter G, Chapter 301, Occupations Code, Section 301.4535(a). HB 4123 by Representative Ryan Guillen Relates to the dissemination of criminal history record information by the Department of Public Safety. HB 4123 amends the NPA, Subchapter G, Chapter 301, Occupations Code, Sections 301.2511(a), and (c). Senate Bill (SB) 1343 by Senator Morgan Lamantia Amends Section 301.051 of the Occupations Code to increase the size of the Board to 15 members. The two new positions on the Board will include an additional Advanced Practice Registered Nurse (APRN) representative and an additional consumer representative. Requires the Board to adopt rules to appoint APRNs to review and assist with complaints and investigations related to alleged standard of care violations by APRNs. The APRN reviewer must practice within the same role and population focus and must provide for the report of the expert reviewer to be included with notice of informal proceedings. The rules required by this section must be adopted no later than February 1, 2024. SB 1429 by Senator Chuy Hinojosa Prohibits the use of a standardized examination as a graduation requirement or to deny students an affidavit of graduation. Lists acceptable uses of standardized examinations. Requires
rules related to the use of standardized exams to be adopted as soon as practicable after the effective date. SB 1429 adds new Section 301.1571 to the NPA. SB 1659 by Senator Charles Schwertner SB 1659 amends Sec. 301.003 to postpone review of the Board of Nursing and other agencies by the Sunset Advisory Commission from the 20282029 review cycle to the 2032-2033 review cycle.
Other Bills Relating to Nursing HB 44 by Representative Valoree Swanson Under HB 44, a provider who participates in Medicaid or the child health plan program may not refuse to provide health care services to a Medicaid recipient or child health plan program enrollee based solely on the recipient’s or enrollee’s refusal or failure to obtain a vaccine or immunization for a particular infectious or communicable disease. HB 49 by Representative Stephanie Klick Amendments to the Health and Safety Code will now require public access to certain hospital investigation information and materials. HB 473 by Representative Lacey Hull Before a school’s Threat Assessment and Safe and Supportive School Team can conduct a threat assessment of a student the team must notify a parent or other person standing in parental relation and provide them with the opportunity to participate. Following completion of the assessment the parent or other person shall be given the findings and conclusions of the 7
assessment. School nurses working in support of these teams will need to be aware of the requirements of this bill to ensure compliance. HB 617 by Representative Drew Darby HB 617 establishes a pilot program for emergency telemedicine services in rural areas. Aims to provide emergency medical services instruction via telemedicine to healthcare and EMS providers in rural areas. HB 755 by Representative Julie Johnson HB 755 amends Chapter 1369 of the Insurance Code to prohibit most health benefit plans that provide prescription drug benefits from requiring an enrollee to receive more than one prior authorization annually for prescription drugs used to treat an autoimmune disease, hemophilia, or Von Willebrand disease. Some exceptions apply. APRNs who prescribe these drugs and nurses who work with patients who take these drugs should be aware. HB 852 by Representative Shawn Thierry HB 852 amends Chapter 34 of the Health and Safety Code to expand the membership of the Texas Maternal Mortality and Morbidity Review Committee to include additional members whose areas of expertise are not currently represented. There was no change to the existing nursing representation on this committee. HB 916 by Representative Claudia Ordaz HB 916 amends Chapter 1369 of the Insurance Code to require most health benefit plans that provide benefits for continued on next page
Legislative Summary - cont. from prev. page prescription contraceptive drugs to provide for an enrollee to obtain up to a three-month supply at one time the first time the enrollee obtains the drug and a 12-month supply at one time each subsequent time the enrollee obtains the drug. APRNs who prescribe these drugs and nurses who work with patients who take these drugs should be aware. HB 1106 by Representative Vikki Goodwin Following passage of HB 1106, the Texas Medical Board may set the training and certification process for an acudetox specialist to provide acupuncture services. HB 1211 by Representative Ryan Guillen HB 1211 relates to repayment of certain mental health professional education loans, including APRNs, who hold a nationally recognized board certification in psychiatric or mental health nursing. HB 1337 by Representative Lacey Hull Amends Chapter 1369 of the Insurance Code to limit the authority of health benefit plans to require enrollees who are 18 years or older and diagnosed with serious mental illness to complete step therapy protocols before the insurer will provide coverage for certain prescription drugs. Health benefit plans may implement a step therapy protocol to require the trial of a generic or pharmaceutical equivalent of a prescribed prescription drug only once in a plan year and only if the generic or pharmaceutical equivalent drug is added to the plan’s drug formulary. APRNs who diagnose and treat serious mental illness and nurses who work with these patients should be aware of the changes. HB 1488 by Representative Toni Rose The Health and Safety Code will outline the establishment of the sickle
cell task force and the work to be accomplished to improve health care relating to sickle cell disease. HB 1647 by Representative Cody Harris HB 1647 amends Chapter 1369 of the Insurance Code to prohibit most health benefit plans from requiring enrollees with chronic, complex, rare, or life-threatening medical conditions to obtain clinician-administered drugs dispensed only by certain pharmacies or only by pharmacies participating in the health benefit plan issuer’s network or to limit or exclude coverage for such drugs based on the enrollee’s choice of pharmacy. Additionally, the health benefit plan cannot require a provider to bill for reimbursement for delivery and administration of the clinician-administered drug under the pharmacy benefit rather than the medical benefit without informed written consent of the patient and a written attestation from the provider that a delay in the drug’s administration will not place the patient at increased health risk. Additionally, the enrollee cannot be required to pay additional fees or higher copays, or other price based on the enrollee’s choice of pharmacy if certain criteria are met. APRNs and nurses who practice in settings in which these patients are administered these drugs should be aware. HB 1673 by Representative Giovanni Capriglione Nurses, including nurse managers and direct care staff members, who work in assisted living facilities that provide care to residents with Alzheimer’s disease and related disorders are required to complete training and receive annual continuing education training on Alzheimer’s disease, related disorders, and care of residents with these conditions. HB 1673 only applies to assisted living facilities that do not hold a license classified under section 247.029 Facilities for Persons 8
with Alzheimer’s Disease of the Texas Health & Safety Code. The Texas Health and Human Services Commission (HHSC) will implement new rules to meet the requirements outlined in the bill. Staff do not have to complete training until December 31, 2024. HB 1890 by Representative Jacey Jetton Amends the Health and Safety Code, creating an application, approval process, and minimum standards for the operation of a hospital at home program by certain hospitals, authorizing a fee. HB 2727 by Representative Four Price HB 2727 establishes Medicaid reimbursement for telemonitoring services for individuals with certain conditions: pregnancy, diabetes, heart disease, cancer, COPD, hypertension, congestive heart failure, asthma, myocardial infarction, stroke, end stage renal disease and/or mental illness. These individuals must have at least one of the qualifying risk factors. The information gathered has to be gathered by a qualifying entity. HB 3009 by Representative Gary VanDeaver Amends Chapter 1101 of the Estates Code to permit an APRN to conduct examinations and issue letters or certificates of incapacitation of an adult for purposes of guardianship. The APRN must have delegated authority from the physician to provide this service, and the delegating physician must co-sign the letter or certificate issued by the APRN. HB 3162 by Representative Stephanie Klick Nurses who are involved in direct patient care and care coordination should be aware of what happens when an attending physician refuses to honor advance directives or a pacontinued on next page
Legislative Summary - cont. from prev. page tient’s healthcare/treatment decision. HB 3162 includes updates to this process which involves review of the refusal by ethics or medical committee and care coordination among the physician, healthcare team, patient, and family to resolve disagreements about patient care and treatment decisions. HB 3286 by Representative Stephanie Klick HB 3286 amends Chapter 531 of the Government Code adds protections for exceptions to the Texas Medicaid prescription drug formulary that will give Medicaid patients exceptions under certain conditions. Will allow patients who are stable on a drug to obtain an exception if a change in the drug would be expected to be ineffective or to cause harm to the patient. The bill also creates a database for providers to determine if drugs are on the state’s preferred drug list. APRNs who prescribe drugs to Medicaid patients and nurses working with these patients need to be aware of this change. The database will provide an additional resource for nurses at all levels of licensure who work with these patients. HB 4375 by Representative Gary VanDeaver A school district or open-enrollment charter school shall provide instruction to students in grades 7 through 12 in cardiopulmonary resuscitation and the use of an automated external defibrillator.
must be made directly to the commission, instead of to the Department of Family and Protective Services. HB 4888 by Representative Cole Hefner HB 4888 amends Chapter 32 of the Human Resources Code to permit providers who provide non-opioid treatment services to include drugs or biological products to be reimbursed separately under Medicaid to the extent permitted under federal law. Non-opioid treatment is defined to mean a drug or biological product that is indicated to produce analgesia without acting on the body’s opioid receptors. APRNs who provide such services need to be aware. SB 24 by Senator Lois Kolkhorst Transfer of powers and duties of various programs from the Department of Family and Protective Services to Health and Human Services Commission, including the Nurse-Family Partnership competitive grant program and the Texas Home Visiting Program. SB 25 by Senator Lois Kolkhorst SB 25 amends Section 61.651(1), Education Code: Provides funding for an initial or an advanced degree in professional nursing in the form of scholarships and loan repayment. Specific criteria are set forth for eligibility to receive the funds. Part-time and full-time nursing program faculty are eligible to apply for these funds. This bill is meant to assist with the nursing and nursing faculty shortage.
HB 4696 by Representative Candy Noble
SB 240 by Senator Donna Campbell
Nurses working in long-term care facilities licensed by or in contract with HHSC should be aware of updated reporting requirements related to reports of abuse, neglect, or exploitation of residents or patients, including the reporting of suspected abuse, neglect or exploitation. These reports
Facilities, as defined by the bill, to include home and community support services agencies, hospitals, nursing facilities employing at least two registered nurses, ambulatory surgical centers, freestanding emergency medical care facilities, and mental hospitals, shall establish a workplace violence prevention committee or authorize 9
an existing committee to develop a workplace violence prevention plan. A facility shall adopt, implement, and enforce a written workplace violence prevention policy and plan to protect health care providers and employees from violent behavior and threats of violent behavior occurring at the facility. The committee must include at least one RN that provides direct care to patients of the facility. SB 294 by Senator Nathan Johnson Changes references in the education code relating to the use of unassigned asthma medication and the use of “medication for respiratory distress.” Public and private schools may adopt and implement a policy regarding the training of staff and the maintenance, administration, and disposal of medication for respiratory distress. Nurses working in school settings that will implement such policies should be aware of the requirements of this bill. SB 401 by Senator Lois Kolkhorst SB 401 prohibits price gouging by a medical staffing service during a designated public health disaster period. SB 629 by Senator Jose Menendez Public and private schools serving students in grades 6 through 12 shall adopt and implement policies regarding the training of staff and the maintenance, administration, and disposal of opioid antagonists. Schools serving students in a grade level below grade 6 may adopt such policies. Nurses working in school settings that will implement such policies should be aware of the requirements of this bill. SB 745 by Senator Lois Kolkhorst SB 745 amends Chapter 36 of the Human Resources Code to expand the scope of the Texas Medicaid Fraud Prevention Act and authorize the Office of the Attorney General to investigate and pursue civil enforcement continued on next page
Legislative Summary - cont. from prev. page actions to deter fraudulent conduct and recover funds from providers committing unlawful acts associated with health care programs funded by the state. Such programs include Medicaid, the Children’s Health Insurance Program (CHIP), and the Healthy Texas Women program. Nurses who may be found to have engaged in such conduct may be reported to the BON for enforcement action. This has the potential to result in additional complaints and investigations if nurses are found to be involved. SB 840 by Senator Royce West Deters and punishes violence against healthcare workers in the workplace by enhancing the penalty for assault from a Class A misdemeanor to a third-degree felony if the victim is a hospital employee on hospital property. SB 867 by Senator Royce West The Opioid Antagonist Program, operated by the executive commissioner of the Health and Human Services Commission, may provide opioid antagonist under the program to institutions of higher education as defined by Section 481.134. SB 989 by Senator Joan Huffman SB 989 adds Chapter 1372 to the Insurance Code to require certain health benefit plans to provide coverage for biomarker testing for the purpose of diagnosis, treatment, appropriate management, or ongoing monitoring of an enrollee’s disease or condition to guide treatment when that test is supported by certain medical and scientific evidence as described in the Chapter. Nurses who work in settings in which biomarker testing is offered and meets the parameters set forth in the statute should be aware.
SB 1319 by Senator Joan Huffman Following passage of SB 1319, emergency medical service personnel must report certain overdose information, including a registered nurse, or other health care practitioners licensed by this state, that staff an emergency medical services vehicle regularly. SB 1506 by Senator Bryan Hughes The parent of guardian of a student may seek care for the student’s seizures while at school or participating in a school activity by submitting a seizure management and treatment plan developed by themselves in collaboration with the physician responsible for the student’s seizure treatment. The plan must be on a form meeting the requirements specified in the bill. The Texas Education Agency shall adopt and post on the agency ’s Internet website the form required under Section 38.032(b), Education Code, as amended by this Act. Significant for school nurses. SB 2133 by Senator Borris Miles SB 2133 requires that each applicable emergency medical services provider have a plan for providing a dialysis patient who places an emergency 9-1-1 telephone call during a declared disaster an alternative mode of transportation directly to and from an outpatient end stage renal disease facility if the patient’s normal and alternative modes of transportation cannot be used during the disaster. SB 2193 by Senator Morgan Lamantia SB 2193 outlines details of the federally qualified health center primary care access program that provides primary care access to certain employees. SB 2479 by Senator Judith Zaffirini SB 2479 makes amendments to procedures concerning persons who are or may be persons with a mental illness or intellectual disability. 10
Sale of Computerized Lists Discontinued in Response to Changes to the Public Information Act The Texas Board of Nursing (BON or Board) no longer offers for purchase computerized lists including Registered Nurses, Licensed Vocational Nurses, and Advanced Practice Registered Nurses. These lists were provided under the authority of the Public Information Act, Texas Government Code, Chapter 522, which requires release of public information pursuant to a lawful request from the public. On September 1, 2023, section 552.11765 of the Public Information Act was amended to prohibit release of certain information for all occupational licensees throughout the state. Changes to the Public Information Act make all license applications, home addresses, home phone numbers, email addresses, driver license numbers, passport numbers, and contact information restricted from public disclosure. The Board will make an announcement concerning what information will be offered through the BON website and how it will be provided in the next few months.
Ready or Not, More AI Tools are Coming to Your Nursing Practice Setting by Christine Riley, MSN, RN
Introduction Every nurse remembers the day they took their licensure exam. If a nurse was licensed before 1994, the nurse may have even taken that exam with a pencil and test booklet and waited up to twelve weeks for the results! The National Council of State Boards of Nursing (NCSBN) began conducting studies with computer adaptive testing (CAT) in 1986 and administered the first National Council Licensure Examination (NCLEX) exam via CAT on April 1, 1994 (NCSBN, 2014). With CAT, the computer automatically selects questions from a pool and adapts subsequent questions based on previous responses. For many nurses, this exam may have been one of their first exposures to artificial intelligence (AI) in the field of nursing. The umbrella term AI describes the tools and techniques which are used to teach computers to mimic human-like cognitive functions, such as learning, reasoning, communicating and decision making (Robert, 2019; von Gerich, et al., 2022). Thoughts of AI may go straight to human-like robots, but AI is much broader than that. Think about when a cell phone application for driving directions automatically reroutes the driver based on traffic patterns, or asking a digital assistant such as “Alexa” or “Siri” what the latest
news headlines are. The examples are endless and continue into the healthcare and nursing realms, such as smart insulin pens, or automated alerts that pop up after analyzing data in electronic health records. The purpose of this article is to give a glimpse into the state of AI as it relates to healthcare and safe nursing practice. This snapshot is not a comprehensive review as AI in healthcare is accelerating at a rapid pace and contains numerous types of technology, not all of which are discussed here. However, nurses should be aware of the general terms related to AI, and how to incorporate these tools in nursing practice while followingTexas Board of Nursing (BON or Board) rules and regulations. The research process for this article started with a review of NCSBN Environmental Scans over the last five years and a search in PubMed of the following terms in “title/ abstract”: artificial intelligence, AI, healthcare, health, AND care, and the following terms in any field: nurse AND nursing. Results were limited to those written within the last five years and with free access so readers could refer to resources as well. It should also be mentioned that an AI tool, ChatGPT, was used to create an initial outline for this article, which was then modified by this author. ChatGPT 11
is an example of a large language model (LLM). This type of model is designed to process enormous amounts of text data to learn language patterns and mimic human intelligence. See Diagram 1 on page 10 for a visual representation of the AI terms used in this article. Current Applications of AI in Nursing A term that comes up frequently in relation to AI is machine learning (ML). Rong et al.(2022) defined machine learning (ML) as the computerized modeling of various components of the process of acquisition of knowledge. This means ML is a computer’s way of simulating human learning by processing data and algorithms, learning from the data processed to evolve and improve performance over time. The ability of algorithms to self-learn and develop via practice is one of the most important aims of machine learning (Rong, et al., 2022). In one study, utilizing data from electronic health records, this ML approach was applied to find and rank predictive factors of hospitalized patient falls. With the ability to forecast factors that influence patient outcomes, prediction models have the potential to support healthcare provider decision making and ultimately improve quality of care (Lindberg, et al., 2020). cont. on next page
AI Tools in Nursing - cont. from prev. page Examples of ML and Predictive Analytics: Predictive models for: fall risk, pressure injuries, nursepatient ratio assignments
Examples of ML and NLP: speech and text analysis, chatbots
Examples of ML: Computer Adaptive Testing (CAT), virtual simulation, AIAssisted Diagnosis
Example of ML, NLP, and LLM: ChatGPT
Diagram 1: Overview of AI Terms and Examples in the AI Tools in Nursing Ar�cle
Another application of ML for healthcare improvement came via a study that used nursing flowsheet data to identify characteristics of pressure injuries and develop a predictive model for pressure injury events. The authors cited the previous limitations of applying traditional assessment tools, like the Braden Scale, and saw a need for an additional tool, such as a predictive model. While this study was still pending external validation, the initial results concluded that the model accurately predicted pressure injury development and may be helpful in pressure injury prevention (Song et al., 2021). ML often overlaps with predictive analytics to develop these predictive models, like the ones mentioned above for predicting fall risk and pressure injuries. Predictive analytics is the computational analysis of data and statistics to find patterns and predict future outcomes (Wakefield, 2023). When combined, ML and predictive analytics utilize data analysis, statistics, and machine learning algorithms. This approach enables the predictive model to respond to new data
over time, providing a tool for enhanced decision-making. Researchers also incorporated this process in the construction of a predictive model to optimize nurse-patient allocation. Through data collection, analysis of that data and nursing processes, this model demonstrated the high variability of patient care requirements and proposed a method to make more balanced nurse to patient ratio assignments (Moreno-Fergusson et al., 2021). Remote patient monitoring can also be applied with AI in nursing. This term encompasses devices that allow a health care team to monitor a patient’s vital signs and changes in condition from a distance (NCSBN, 2019; NCSBN 2023). Examples of remote monitoring tools might include blood pressure monitors, pulse oximeters, cardiac event recorders, positive airway pressure machines, and physical activity trackers. One of the studies reviewed focused on remote monitoring of patients in their homes with the use of sensors. The continuous sensor-based monitoring of patients in their “smart homes” provided clinical insight
into symptoms experienced by older adults between office visits. Patient data collected from these sensors and ML algorithms were used to provide automated detection of health events. The study found that nurses could use this data to initiate preventive strategies and provide timely intervention to avoid adverse health events (Fritz, et al., 2022). AI-assisted diagnosis also came up in the review of AI in healthcare. Research from the National Library of Medicine defined medical diagnostics as the “process of evaluating medical conditions or diseases by analyzing symptoms, medical history and test results” (Al-Antari, 2023). When AI is used to assist in medical diagnostics, providers incorporate mechanisms to interpret massive amounts of patient data, such as algorithms to analyze medical images (e.g., X-rays, MRIs, ultrasounds, CT scans, and DXAs), vital signs, medical history, lab test results and demographic information. Findings can allow healthcare providers to identify and diagnose diseases more accurately and quickly (Al-Antari, 2023). There has been concern for the potential of misdiagnosis, leading to incorrect or potentially unsafe treatment options. However, some ML methods associated with AI assisted diagnosis may be more accurate at diagnosing a health condition, such as detecting a cancer via image analysis, where a human might have missed the finding (NCSBN, 2019; Fakoor et al., 2013; Vial et al., 2018 as cited in NCSBN, 2020). AI researchers and clinicians have emphasized that the final word, continued on next page
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AI Tools in Nursing - cont. from prev. page decision, diagnosis, and treatment choices should not be made by AI. Rather, AI can be a tool for practitioners, or offer a complementary role in the diagnostic process. It would be hard to give a full picture of AI in healthcare without talking about robotics. On its own, robotics is defined as the “engineering and operation of machines that can autonomously or semi-autonomously perform physical tasks on behalf of a human” (Soriano et al., 2022). Robots routinely perform simple tasks such as automated medication reminders or deliver a medication to a patient in isolation. One article showed how robots are assisting the elderly with tasks such as bathing, task reminders, monitoring, supervising wellness activities, giving exercises for cognitive stimulation, and music therapy (Rong et al., 2022). Robots alone do not incorporate AI, but the combination of robots with AI is emerging in healthcare. Natural language processing (NLP) is a branch of AI where computers analyze text or speech data and mimic human understanding. This mechanism was illustrated in one study where nurse chatbots simulated conversation with patients to assist with self-management of chronic diseases, and increase access to healthcare information (Hernandez, 2019). The large language model (LLM) mentioned earlier, ChatGPT, is a specific application of NLP which goes beyond basic text analysis and uses advanced algorithms to learn from vast amounts of data and generate convincingly human-like text.
When these elements of AI, such as NLP, LLM and ML, are combined with the physical hardware or “body” of a robot, these AI embedded robots have the potential to modify and adapt behavior and perform more complex tasks. Such tasks may include communicating with persons with limited social participation and engagement, serving as a companion, or tailoring therapeutic activities to an individual’s needs (Rong et al., 2022; Soriano et al., 2022). Researchers have described robotics in nursing as “systems of mechanical, electrical, and control mechanisms used by trained operators in a professional health care setting that perform tasks in direct interaction with patients, nurses, doctors, and other health care professionals” (von Gerich et al., 2022; Soriano et al., 2022). These systems can “modify their behavior based on what they sense in the environment” (von Gerich et al., 2022; Soriano et al., 2022). Some of these authors recommended approaching robotics in nursing as a “three-party relationship between patients, nurses (healthcare professionals), and robots and to effectively use robots and AI as tools and technologies in this relationship” (Soriano et al., 2022). It is also important to clarify how the robot should function in each environment and among team members and for the healthcare team to provide feedback for developing new robots. AI can also be incorporated into nursing school curriculum and 13
training to prepare future nurses for the use of such technology in the workplace (Pepito & Locsin, 2019; Thibault, 2020 as cited in NCSBN, 2021). Similar to how CAT personalizes the exam to the student, virtual simulations offer an individualized learning experience. The NCSBN Environmental Scan from 2023 showcased an example from the Ohio State College of Nursing which partnered with College of Engineering to build “extended reality learning tools” to prepare student nurses for clinical settings and test them on clinical scenarios (NCSBN, 2023). These adaptive learning experiences challenge students at their current level of competency and can be especially useful where clinical experiences are hard to come by. Benefits and Challenges of AI in Nursing The use of AI tools offers potential benefits to nurses and patients. This article has covered examples of AI assisting in decision making with healthcare providers through AI assisted diagnosis and the use of AI generated tools to predict adverse health events or craft balanced nurse-patient ratio assignments (Lindberg, et al., 2020; Song et al., 2021; Fritz, et al., 2022; Moreno-Fergusson, et al., 2021). There are also some aspects of AI which could be interpreted as a challenge or benefit to the nursing profession. While some have expressed fear that AI could eventually take over jobs, the nursing workforce is facing increasing demands with more complex continued on next page
AI Tools in Nursing - cont. from prev. page patients, and the added stresses of frequent staffing shortages and burnout, which were only exacerbated by the COVID-19 pandemic. Researchers have estimated that by the year 2025, the US may have a gap of 200,000 to 450,000 nurses (Berlin et al., 2022, as cited in NCSBN, 2023). Texas has one of the lower ratios of employed RNs per population with fewer than 750 RNs per 100,000 people (U.S. Bureau of Labor Statistics, 2022 as cited in NCSBN 2023). With the current nursing shortage in many parts of the US and anticipated worsening shortage of nurses, it’s important to consider how AI tools can help address the nursing shortage, reduce risk of burnout, and compensate for nurses leaving the workforce (NCSBN, 2023). Novel technologies may not take the place of a nurse any time soon, but many envision changes in nursing roles and responsibilities due to AI integration. There may be different competencies and skills for nurses to learn in healthcare environments which incorporate AI tools. A report by McKinsey Global Institute argues that there is already a robotic revolution happening in nursing and these robots have made tasks and procedures more efficient and safer (McKinsey Global Institute, 2017 as cited in Pepito & Locsin, 2019). Pepito and Locsin provided examples of how robots are already working in hospitals as supplemental healthcare workers, as companions, and automated medication dispensers (Pepito & Locsin, 2019). Beyond select nursing tasks, researchers have expressed concerns regarding
the capability of robots to express human like characteristics, such as compassion, and empathy (Mason, 2021; van Wynsberghe, 2014 as cited in Soriano et al., 2022). Furthermore, nurses have skills that AI has a harder time replicating, such as critical thinking and reacting accordingly to unpredictable human behavior and emotions which are subjective and constantly changing (Pepito& Locsin, 2019). One of the challenges of AI in nursing was cited in the literature review by von Gerich et al., which found that AI research applicable to nursing lacks comprehensive evaluation of outcomes regarding the subject of the AI project (von Gerich et al., 2022). Not every new tool is better than what was used before, and it is important to verify usefulness and explain to nurses how the given tool will benefit their practice and patient care. These researchers also found a “sparsity of nurses in AI development”, highlighting the need for more nurse involvement and understanding of AI tools. Future Directions and Implications for Nursing It helps that nurses are naturally set up for innovation by way of working in healthcare settings and fields that are constantly evolving. Nurses must learn how to adapt to advancing technology, how to supplement and enhance skills, and ultimately determine the trajectory of how the nursing profession is to impact and work with advancing technologies (Pepito & Locsin, 2019). Nurses are poised to advocate for the use of 14
AI tools in their practice area or come up with their own devices to advance methods of patient care and improve healthcare outcomes. Remember that the standards of nursing practice require nurses of all levels of licensure to make a reasonable effort to obtain orientation/training for competency when encountering new equipment and technology or unfamiliar care situations [Board Rule 217.11(1)]. Another standard requires nurses to be responsible for their own continuing competence in nursing practice and individual professional growth [Board Rule 217.11(1)(R)]. Research indicates that whether nurses are directly involved in AI development or not, it benefits nurses to help decide which aspects of their role can be enhanced with technology and which aspects cannot, while ensuring the needs of the patient are met (Pepito & Locsin, 2019). With so many opportunities for AI to be involved in nursing and patient care, the onus is on nurses to uphold the Nursing Practice Act and all Board Rules when incorporating AI tools into practice, such as clarifying any order or treatment regimen that the nurse believes is inaccurate, non-efficacious, or contraindicated by consulting with the appropriate licensed practitioner, notifying the ordering practitioner when the nurse makes the decision to not carry out the order or treatment, and collaborating with the healthcare team in the best interest of the patient [Board Rule 217.11(1) (N) & (P)]. continued on next page
AI Tools in Nursing - cont. from prev. page When incorporating novel technology such as AI into nursing practice, nurses should also consider the ethical principles of nursing and how those relate to the use of AI. One of these ethical principles is autonomy, or the freedom to choose and goes along with being a patient advocate. Nurses must be informed and able to educate patients on all elements of the care plan so the patient can make an informed decision [Board Rule 217.11(1)(F)]. Similarly, when it comes to making decisions regarding a patient’s healthcare, that decision is ultimately made by the patient and healthcare provider, while possibly making use of AI tools (WHO, 2021, as cited in NCSBN, 2022). Another ethical principle is non-maleficence, or “do no harm”. AI should not be harmful but should support the principle of beneficence or “doing good”. Patient safety is paramount in nursing care and nurses are obligated to implement measures to promote a safe environment for others [Board Rule 217.11 (1)(B)]. The World Health Organization (WHO) also supports that AI must be transparent, inclusive, and equitable, which goes along with other ethical principles of fidelity and justice (WHO, 2021, as cited in NCSBN, 2022). If using AI generated tools such as algorithms, nurses should be aware of potential biases and how certain algorithms may work better for some populations, because those algorithms were only tested among certain populations (von Gerich et al., 2022; NCSBN, 2020). For nurses working in the development of AI tools, it’s important to be aware
of biases in data collection and know who the technology is being developed for, the end users, the intended population, the intended setting, intended age group, etc., and incorporate those stakeholders in the development [Board Rule 217.11(1)(L)]. Researchers and developers should also make efforts to ensure accessibility of these tools benefit all populations and healthcare settings. Conclusion Just as all nurses should know how to take a manual blood pressure in case the blood pressure machine malfunctions or to double-check a reading, the nursing knowledge, skills, and judgment from human nurses are essential in the provision of safe patient care, regardless of whether AI tools are used. With respect to evolving technology and AI, the Board continues with the mission 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. AI is either already in a nurse's area of practice or will be coming soon, and it is up to nurses to incorporate AI into their practice safely. References 22 Texas Administrative Code, §217.11 (2007). https://www.bon.texas.gov/ rr_current/217-11.asp.html Al-Antari M. A. (2023). Artificial intelligence for medical diagnostics-existing and future AI technology. Diagnostics (Basel, Switzerland), 13(4), 688. https://doi. org/10.3390/diagnostics13040688 Berlin, G., Lapointe, M., Murphy, M., 15 11). Assessing & Wexler, J. (2022, May
the lingering impact of COVID-19 on the nursing workforce. McKinsey & Company. https://www.mckinsey.com/industries/ healthcare-systems-and-services/our-insights/assessing-the-lingering-impact-ofcovid-19-on-the-nursing-workforce Fakoor, R., Ladhak, F., Nazi, A., & Huber, M. (2013, June). Using deep learning to enhance cancer diagnosis and classification. In Proceedings of the international conference on machine learning (Vol. 28). New York, USA: ACM. Fritz, R., Wuestney, K., Dermody, G., & Cook, D. J. (2022). Nurse-in-the-loop smart home detection of health events associated with diagnosed chronic conditions: A case-event series. International journal of nursing studies advances, 4, 100081. https://doi.org/10.1016/j.ijnsa.2022.100081 Hernandez, J.P. (2019). Network diffusion and technology acceptance of a nurse chatbot for chronic disease self-management support: A theoretical perspective. The Journal of Medical Investigation, Volume 66 Issue 1.2 Pages 24-30. https:// doi.org/10.2152/jmi.66.24 Lindberg, D. S., Prosperi, M., Bjarnadottir, R. I., Thomas, J., Crane, M., Chen, Z., Shear, K., Solberg, L. M., Snigurska, U. A., Wu, Y., Xia, Y., & Lucero, R. J. (2020). Identification of important factors in an inpatient fall risk prediction model to improve the quality of care using EHR and electronic administrative data: A machine-learning approach. International journal of medical informatics, 143, 104272. https://doi.org/10.1016/j.ijmedinf.2020.104272 Mason, C. (2021). Artificial Compassion—From An AI Scholar. Preprints 2021. https://doi:10.20944/preprints202104.0784.v1 McKinsey Global Institute. (2017). JOBS LOST, JOBS GAINED: workforce transitions in a time of automation. San Francisco: McKinsey & Company. Moreno-Fergusson, M. E., Guerrero Rueda, W. J., Ortiz Basto, G. A., Arevalo Sandoval, I. A. L., & Sanchez-Herrera, B. (2021). Analytics and lean health care to address nurse care management challenges for inpatients in emerging economies. Journal of nursing scholarship : an official publi-
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Jan Hooper Elected to Second Term on the NCSBN Leadership Succession Committee The Texas Board of Nursing (BON or Board) is proud to announce Lead Nursing Education Consultant Dr. Janice Hooper was elected during the August 2023 gathering of the National Council of State Boards of Nursing (NCSBN) Delegate Assembly to serve a second term on the Leadership Succession Committee.
In 2002, Dr. Hooper returned to her native Texas and joined the Board staff as an Education Consultant and was appointed Lead Consultant in 2009. She was inducted into the NCSBN Fellowship of the Institute for Regulatory Excellence in 2012, served as Chair of the NCSBN NCLEX Examination Committee for five years, and chaired the NCSBN Education Outcomes and Metrics Committee for two years. Dr. Hooper is a Fellow in the Academy of Nursing Education (ANEF) and a Fellow in the American Academy of Nursing (FAAN). Further, she is certified by the National League for Nursing in nursing education. Dr. Hooper is a prolific nursing researcher and author. Her works are found in the NCSBN’s Journal of Nursing Regulation and Leader to Leader. Congratulations, Dr. Hooper!
Janice I. Hooper, PhD, RN, FRE, CNE, FAAN, ANEF, began her nursing career as an associate degree nursing graduate from Maryville University in St. Louis, Missouri. She holds a Baccalaureate Degree in Nursing, a Masters Degree in Nursing (MSN) in Nursing of Children, and a PhD from St. Louis University. As a lifelong learner, Dr. Hooper completed four additional master’s degrees: an MSN in Community Health from the University of Missouri-Columbia and Masters Degrees in Management, Early Childhood Development, and Counseling from Webster University in St. Louis. While engaged in these educational pursuits, Dr. Hooper served as a nursing program faculty member, program director, and department dean in the St. Louis area for over 20 years.
AI Tools in Nursing - cont. from prev. page cation of Sigma Theta Tau International Honor Society of Nursing, 53(6), 803–814. https://doi.org/10.1111/jnu.12711 National Council of State Boards of Nursing (NCSBN). (2014). Pencils down, booklets closed. In Focus. (Spring 2014, pp 10-13). National Council of State Boards of Nursing (NCSBN). (2019). The NCSBN 2019 environmental scan: 40th anniversary edition. Journal of Nursing Regulation, S1-S40, 9(4). https://doi: 10.1016/S21558256(18)30177-7 National Council of State Boards of Nursing (NCSBN). (2021). NCSBN’s environmental scan COVID-19 and its impact on nursing and regulation. Journal of Nursing Regulation, S1-S36, 11(4). https:// Doi:10.1016/S2155-8256(21)00002-8 National Council of State Boards of Nursing (NCSBN). (2023). The NCSBN 2023 environmental scan: Nursing at a crossroads--an opportunity for action. Journal of Nursing Regulation, S10-S48, 13(4). DOI: 10.1016/S2155-8256(23)00006-6 Pepito, J.A., and Locsin, R. (2019). Can nurses remain relevant in a technologically advanced future? International Journal of Nursing Sciences. 106-110. https:// DOI: 10.1016/j.ijnss.2018.09.013
Robert, N. How artificial intelligence is changing nursing. Nurs Manage. (2019) Sep;50(9):30-39. https://doi: 10.1097/01. NUMA.0000578988.56622.21. PMID: 31425440; PMCID: PMC7597764. Song, W., Kang, M. J., Zhang, L., Jung, W., Song, J., Bates, D. W., & Dykes, P. C. (2021). Predicting pressure injury using nursing assessment phenotypes and machine learning methods. Journal of the American Medical Informatics Association : JAMIA, 28(4), 759–765. https://doi. org/10.1093/jamia/ocaa336 Soriano, G.P., Yasuhara, Y., Ito, H., Matsumoto, K., Osaka, K., Kai, Y., Locsin, R., Schoenhofer, S., and Tanioka, T. (2022). Robots and robotics in nursing. Healthcare 2022, 10, 1571, 10(8). https://doi. org/10.3390/healthcare10081571 Thibault, G. E. (2020). The future of health professions education: Emerging trends in the United States. FASEB BioAdvances, 2(12), 685–694. https://doi.org/10.1096/ fba.2020-00061 U.S. Bureau of Labor Statistics. (2022). Occupational Employment Statistics. Retrieved from, http://www.bls.gov/oes/ oes_emp.htm van Wynsberghe, A. (2015). Healthcare robots: Ethics, design and implementa16
tion in emerging technologies. Ethics and International Affairs; Routledge: London, UK, 2015. ISBN 9781032098609 Vial, A. Stirling, D., Field, M., Ros, M., Ritz, C., Carolan, M. & Miller, A.A. (2018). The role of deep learning and radiomic feature extraction in cancer-specific predictive modelling: a review. Translational Cancer Research, 7(3), 803-816. von Gerich, H., Moen, H., Block, L., Chu, C., DeForest, H., Hobensack, M., Michalowski, M., Mitchell, J., Nibber, R., Olalia, M., Pruinelli, L., Ronquillo, C., Topaz, M., and Peltonen, L. (2022). Artificial intelligence-based technologies in nursing: A scoping literature review of the evidence. International Journal of Nursing Studies. Mar;127:104153. https://doi: 10.1016/j. ijnurstu.2021.104153. Epub 2021 Dec 7. PMID: 35092870. Wakefield, K. (2023). Predictive modeling analytics and machine learning. SAS Institute. Retrieved from https:// www.sas.com/en_gb/insights/articles/ analytics/a-guide-to-predictive-analytics-and-machine-learning.html World Health Organization. (2021). Ethics and governance of artificial intelligence for health. WHO Guidance. https://apps. who.int/iris/handle/10665/341996. License: CC BY-NC-SA 3.0 IGO
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IMPOSTER WARNING
Beginning September 1, 2023, nurses only receive license expiration reminder notifications by email if the nurse is enrolled in the National Council of State Boards of Nursing (NCSBN) Nursys e-Notify system. The Texas Board of Nursing ceased mailing yellow postcards to licensees notifying nurses that they are eligible to renew on August 31, 2023. To make sure you receive renewal expiration reminders by email from Nursys e-Notify, register for a free Nurse account from Nursys.com. If you already have a Nurse account with Nursys e-Notify, you do not need to re-register. There is no cost to create an “As a Nurse” account on Nursys e-Notify.
If you have any knowledge or information regarding the employment practices of the following individual or any nurse imposter, please contact the Board’s Enforcement Division immediately at (512) 305-6838.
BON Task Force Plans Statewide Nursing Summit The first meeting of the Task Force to Study Implications of Growth in Nursing Education Programs in Texas was held on July 31, 2023, in the Barbara Jordan State Office Building. The purpose of this meeting was to begin work on the Texas Board of Nursing (BON or Board)charge to the Task Force to “plan for a 2024 statewide nursing summit in collaboration with the Texas Organization for Nursing Leadership and the Texas Nurses Association.” The meeting was well attended by nurse educators, nurses in clinical practice, and other stakeholders.
Yoeynis Palmero Gonzalez a.k.a. Yoeynis P Gonzalez; a.k.a. Yoeynis Gonzalez On or about July 1, 2022, through September 25, 2022, Yoeynis Palmero Gonzalez secured employment as a Graduate Nurse with an Emergency Center in Houston, Texas, by submitting a transcript from EDP University of Puerto Rico. While employed, Yoeynis Palmero Gonzalez was filling shifts as a Registered Nurse and would be the only nurse on duty to oversee any patients. The Board’s investigation revealed that the date of birth and social security number provided by Yoeynis Palmero Gonzalez to his employer does not belong to any nurse having a license or privilege to practice nursing in the State of Texas.
Keelan Keon Tae Ke Sean Guidry a.k.a. Keelan Guidry; a.k.a. Keelan Keon Guidry; a.k.a. Keelan K Guidry; a.k.a. Keelan Sean Guidry; Keelan S Guidry; a.k.a. Keelan K Sean; a.k.a. Keelan T Guidry; a.k.a. Keelan Keontae Kesean Guidry Nursing Education Taskforce Members in Attendance at the Education Taskforce Meeting, July 31, 2023: Back Row: Serena Bumpus, AJ Stephens, Pamela Lauer, Cindy Weston, Jeremy Burciaga, Grace Werckle, Charlet Blades, Shelley Blackwood, Robin Hayes, Sally Williams; and Ashley King. Front Row: Juanita Soto, Laura Opton, and Pat Yoder-Wise.
The meeting began with a brief review of the previous statewide nursing summit held in 2020, along with a reassessment of the 2020 Texas Nursing Summit Recommendations. Task Force members held in depth discussions related to the planning of the 2024 summit, to include the summit purpose and goals, program format, date, and venue. The Task Force voted unanimously to elect Jeremy Burciaga to serve as the committee chair. The date for the next meeting has yet to be determined. Information will be available on the Board’s website once the meeting date and location are set.
Between August 16, 2022, through September 22, 2022, Keelan Keon Tae Ke Sean Guidry secured employment and represented himself as a Licensed Vocational Nurse (LVN) with a staffing agency in Brentwood, Tennessee, and was contracted with a Hospital in Austin, Texas, by submitting a falsified license verification report belonging to a differently named nurse. While employed, Keelan Keon Tae Ke Sean Guidry provided skilled nursing care to residents including, but not limited to, administering medications. The Board’s investigation revealed that the date of birth and social security number provided by Keelan Keon Tae Ke Sean Guidry to his employer did not belong to any nurse having a license or privilege to practice nursing in the State of Texas. The case has been referred to the Travis County District Attorney’s office for prosecution. 17
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, 333 Guadalupe, Suite 3-460, Austin, Texas 78701-3944.
Name
License Numbers
Adeoye, Vivien Temitope LVN 342620 Ajaja, Stacey Ngozi RN 756070 Alexander, Alysha Michele RN 701399
Discipline
Revoked Revoked Enforced Suspension Warning with Stipulations, Allen, Krista Leigh RN 981190 Deferred Warning with Stipulations, Alonzo, Caleb David LVN 351637 Deferred Alpiger, Megan Zachary RN 916900 & LVN 321520 Voluntary Surrender AP137493, RX 26374 & RN Reprimand with Stipulations An, Suhyun 880407 and Fine Warning with Stipulations Anderson, Deja Rayna LVN 341671 and Fine Andres, Hannah Estudillo RN 741149 Reprimand with Stipulations Asamoah, Sheri LVN 352578 Warning with Stipulations Auriada, Grace RN 1015463 & LVN 312541 Warning with Stipulations Austin, Richard Patrick LVN 351550 Revoked Reprimand with Stipulations Baltrip, Alicia Rackea LVN 347493 and Fine Barnes, Chase C. RN 758054 Revoked Barnhill, Jennifer RN 637595 Revoked Bell, Sheila A. RN 502069 Revoked Bernard, Jill Ann RN 781661 Reprimand with Stipulations Warning with Stipulations Billington, Alivia Breanna LVN 348218 and Fine Bisson, Lisa Ann RN 586213 Revoked Blackwell, Antoya Lakole RN 818569 & LVN 218386 Revoked Boatright, Raven Renee LVN 330166 Warning with Stipulations Bohr, Rhonda Gay RN 514964 Warning with Stipulations Bolin, Leah Gwen LVN 190156 Revoked Bravo, Oliver Daleno RN 874193 Probated Suspension Breit, Kayla Lynn LVN 327669 Warning with Stipulations RN 1095027 & PTP LA RN Bridget, Asia Sakura Warning with Stipulations 209445 Brown, Brandi Lashelle RN 900012 & LVN 321769 Enforced Suspension Brown, Mary Ellen LVN 322901 Warning with Stipulations Warning with Stipulations Bruton, Shanelle Leshay RN 844618 & LVN 215293 and Fine Burgess, Rico T. RN 1058711 Enforced Suspension Bustos, Cindy Michelle RN 821214 Remedial Education, Deferred Camp, Robert Blaine RN 918507 Reprimand with Stipulations Campos, Abelina Gonzalez LVN 335784 Warning with Stipulations Cancino, Vanessa RN 1007262 Warning with Stipulations Cariagakamei, Cileishalyn RN 976977 Voluntary Surrender P. Carpenter, Sidney Brooke RN 983594 Reprimand with Stipulations Carroll, Kayla Leighann RN 989604 & LVN 332442 Remedial Education with Fine Casselberry, Julia Faye LVN 163469 Remedial Education with Fine Warning with Stipulations Chen, Jacqueline Louise RN 638298 and Fine Childress, Alicia Viola LVN 349372 Enforced Suspension Choltko, Michelle L. RN 949982 Voluntary Surrender Chupka, Timothy Allen RN 895971 Warning with Stipulations Clark, Nicole Marie LVN 136964 Probated Suspension Clarke, Arlene E. LVN 222095 Revoked
Action Date 5/9/23 5/23/23 6/8/23 6/13/23 7/20/23 5/3/23 5/9/23 7/20/23 5/9/23 6/13/23 5/9/23 6/13/23 6/13/23 6/13/23 5/9/23 7/20/23 7/20/23 7/20/23 6/13/23 6/13/23 7/20/23 7/20/23 5/9/23 7/20/23 6/13/23 6/13/23 5/17/23 5/9/23 6/13/23 6/20/23 7/11/23 6/13/23 5/9/23 6/13/23 5/9/23 5/9/23 6/12/23 6/22/23 7/20/23 7/18/23 4/21/23 5/9/23 7/20/23 5/9/23
Action Date Cole, Tracy Michelle LVN 305213 Remedial Education with Fine 5/24/23 Colmer, Cecily Marie LVN 223176 Revoked 6/13/23 Reprimand with Stipulations Cornett, Velma Lee LVN 179373 6/13/23 and Fine Warning with Stipulations Cortez, Maribel Villalobos RN 950562 7/20/23 and Fine Warning with Stipulations Cosey, April Peterson RN 868284 7/20/23 and Fine Cunningham, Sheila Susan RN 745468 & LVN 168924 Warning with Stipulations 5/9/23 Curb, Torie A. RN 685179 Warning with Stipulations 5/9/23 Danielson, Lavell RN 753613 & LVN 146778 Limited License 7/19/23 Reprimand with Stipulations Darden, Christal Marie LVN 1004363 7/20/23 and Fine Davis, Elizabeth Woodland PTP OK RN R0126316 Voluntary Surrender 7/31/23 Davis, Tonya Sue Aguilar RN 686696 Reprimand with Stipulations 6/13/23 Delacruz, Albert LVN 175289 Remedial Education with Fine 6/28/23 Deleon, Veronica RN 936112 Warning with Stipulations 7/20/23 Dempsey, Alexandra Lynn RN 942357 Voluntary Surrender 6/1/23 Diaz, Jose Orlando LVN 330947 Revoked 6/13/23 Warning with Stipulations Dozier, Ashli Michelle LVN 348832 6/13/23 and Fine Duncan, Shanqula Denise LVN 336518 Remedial Education 5/31/23 Dyer, Kristel Lee LVN 207758 Voluntary Surrender 4/18/23 Ebhodaghe, Faith Efemena LVN 1034009 Voluntary Surrender 5/8/23 AP113512, RX 5747 & RN Ebreo, Ellie Abordo Remedial Education 5/4/23 688312 Elfstrom, Margaret RN 641792 Revoked 7/20/23 El-Takech, Ali F. RN 1007383 Warning with Stipulations 7/20/23 English, Turquoise PTP LA RN 203194 Reprimand with Stipulations 6/13/23 Ferrier, George Martin LVN 224979 Warning with Stipulations 7/20/23 AP133016, RX 22298 & RN Fevrier, Joy B. Probated Suspension 7/20/23 802477 Frazier, Jennifer Paige RN 820498 Voluntary Surrender 5/10/23 Fritz, Ashley Lea LVN 221238 Revoked 5/9/23 Garbutt, Devany R. LVN 320456 Reprimand with Stipulations 5/9/23 Warning with Stipulations Garcia, Kimberly D. RN 626601 6/13/23 and Fine Garcia, Roberto RN 989029 & LVN 340160 Warning with Stipulations 5/9/23 Gatlin, Sabrina Renay LVN 313707 Revoked 5/9/23 Warning with Stipulations, Gayle, Karyn RN 892136 6/13/23 Deferred Gill, Jaskaran Singh RN 1002192 Remedial Education 7/18/23 Reprimand with Stipulations Gonzales, Heather Anne RN 448938 5/9/23 and Fine Gorden, Audra Elaine LVN 351858 Warning with Stipulations 7/20/23 Gorospe, Lucia Mae RN 621951 Warning with Stipulations 5/9/23 Mendoza Green, Christina Renee LVN 339963 Revoked 5/9/23 Warning with Stipulations Griffin, Daniel F. AP119222 & RN 787827 6/13/23 and Fine Griffin, Natasha Tranice LVN 229504 Enforced Suspension 6/13/23 Griggs, Kathrine Mallory LVN 229719 Voluntary Surrender 7/19/23 Warning with Stipulations Guay, David Michael RN 969048 & LVN 303331 5/9/23 and Fine continued on next page Name
18
License Numbers
Discipline
DISCIPLINARY ACTION - cont. from prev. pg. Name
License Numbers
Kabani, Naila Kane, Tiffany Leeann Kappes, Mary Helen
Action Date
Reprimand with Stipulations and Fine
7/20/23
RN 902108
Warning with Stipulations
7/20/23
RN 946288 LVN 132674 LVN 351142
Warning with Stipulations Enforced Suspension Revoked
7/20/23 7/20/23 6/13/23
LVN 346215
Warning with Stipulations
6/13/23
LVN 137339 PTP AR LVN L041917 AP122545 & RN 669350 RN 691243
Warning with Stipulations Voluntary Surrender Probated Suspension Remedial Education with Fine
7/20/23 6/27/23 6/13/23 5/12/23
RN 821340
Voluntary Surrender
7/12/23
RN 873073 LVN 350820 LVN 180381 AP129980 & RN 1111080 LVN 156318 LVN 233403 RN 601252 LVN 141604 RN 802437 & LVN 226607 RN 801272 PTP FL RN RN9496385 RN 958406 AP130112 & RN 799113 RN 1019238 AP1020302, RX 37079 & RN 844172 RN 852777 LVN 114643
Voluntary Surrender Reprimand with Stipulations Warning with Stipulations Enforced Suspension Enforced Suspension Revoked Remedial Education with Fine Warning with Stipulations Voluntary Surrender Revoked Revoked Warning with Stipulations Remedial Education Revoked
6/26/23 5/9/23 7/20/23 6/14/23 7/20/23 7/20/23 7/11/23 7/20/23 5/5/23 5/9/23 5/9/23 6/13/23 6/27/23 5/9/23
Gubernath, Krystel Marie LVN 349980 Gutierrez-Montanez, Andrew Steven Hall, Austin Lee Hamilton, Gary Don Hankins, Kirsten Lynn Hardeman, Lakeshia Dyanne Hart, Nancy Kaye Hearn, Tisha Michelle Heath, Jennifer Kay Heinold, Kelsey Christine Herring, Elizabeth Jeannette Hickman, Marilee Ann High, Amber Hill, Evette Eva Hinton, Kalvin Holder, Denise Lynn Hunt, Sarah A. Jacks, Kemp Louis Jackson, Byronica Yvette Jackson, Tressie Louise Jernigan, Katrina Toy Jo, Andrew Jones, Adesola Jones, Erik Daniel Josaphat, Pedro
Discipline
Remedial Education with Fine 7/26/23
Kotun, Kehinde Adunola
RN 656829
Kurdi, Maureen Helen La Vine, Irene Anne Lambros, Christopher Peter Lape, Carlos Alberto Laspes, Nicholas Ramon Laury, Stacey Rea
RN 1048955 RN 719331
Remedial Education Warning with Stipulations Warning with Stipulations, Deferred Warning with Stipulations and Fine Warning with Stipulations and Fine Warning with Stipulations and Fine Reprimand with Fine Reprimand with Stipulations
RN 809625
Revoked
RN 699475 & LVN 185875 RN 739565 LVN 181088 AP117432, RX 9005 & RN 705442
Revoked 6/13/23 Remedial Education 5/23/23 Remedial Education with Fine 5/3/23
Kessinger, Adrian Brittany LVN 1014468 Killoran, Argie Jane
RN 795116
Kirkland, Kimberly Dawn LVN 310608
Layne, Cheryl Daniel Leichter, Monica
RN 977716
Lenheim, Joann
LVN 313439
Linsicombe, Amanda Dawn LVN 325012 Lofman, Sheryl RN 612988 Loriaga, Charissa RN 848278 Aguinaldo Macias, Christopher LVN 166934 Mack, Jessica Christina LVN 317848
Voluntary Surrender Warning with Stipulations, Deferred Warning with Stipulations and Fine Remedial Education with Fine Revoked
7/12/23 7/20/23
6/13/23
6/13/23 5/9/23 5/9/23 5/9/23 6/13/23 7/20/23
5/30/23 6/13/23 7/20/23 5/5/23 3/29/23
Warning with Stipulations
6/13/23
Voluntary Surrender Warning with Stipulations
6/21/23 6/13/23
Action Date Maina, Caroline Waithera RN 778628 Remedial Education with Fine 7/13/23 Martin, Deadra Regina LVN 165307 Remedial Education with Fine 5/30/23 Martinez Jr., Martin Daniel RN 933493 & LVN 322568 Revoked 4/28/23 Martinez, Mary RN 860581 Enforced Suspension 7/20/23 AP127478, RX 17359 & RN Mathew, Anna T. Remedial Education, Deferred 6/13/23 793789 Mayberry, Judy Mae RN 920549 & LVN 146451 Probated Suspension 6/13/23 Mboob, Fatou Drammeh RN 794648 Revoked 5/9/23 McCain, Cheryl Lynnet RN 533802 Limited License 6/7/23 Meharry, Esther Belinda AP109879 & RN 433345 Remedial Education with Fine 5/24/23 Miller, Roxy Annette LVN 315547 Enforced Suspension 6/14/23 Molla, Sophia RN 955560 Revoked 5/9/23 Monks, Jody PTP OK RN R0109277 Remedial Education 7/26/23 Montes, Luis Ballocanag RN 736212 Remedial Education with Fine 7/6/23 Moss, Misty Rene LVN 222883 Probated Suspension 7/20/23 Warning with Stipulations Moye, Geneca Kimorie LVN 325368 7/20/23 and Fine Nagasha, Winnie Kamya RN 958665 Warning with Stipulations 5/9/23 AP142001, RX 30564 & RN Nathan, Lynda Warning with Stipulations 7/20/23 968769 Reprimand with Stipulations Nations, Christie Michelle RN 660315 & LVN 162873 6/13/23 and Fine Warning with Stipulations Nelson, Allena Kay RN 850204 5/9/23 and Fine Nelson, Karrie Lyn RN 677751 Revoked 7/20/23 Nguyen, Christina RN 695909 Voluntary Surrender 6/5/23 Gabriella Warning with Stipulations, Nguyen, Johnny Tai RN 912337 7/20/23 Deferred Nnorom, Chioma Ngozi RN 975499 Remedial Education 5/10/23 Northcutt, Michelle Garcia RN 674215 Remedial Education with Fine 6/14/23 Nwankwo, Joseph Uche RN 760602 & LVN 202284 Voluntary Surrender 5/9/23 Obele, Joy Ugonma RN 977851 & LVN 312063 Reprimand with Stipulations 7/20/23 Odia, Osagumwenro LVN 1017698 Voluntary Surrender 5/24/23 Ohale, Evelyn Tochukwu RN 989118 Warning with Stipulations 6/13/23 Ojo, Bosede Ibovbohi RN 876036 Voluntary Surrender 6/23/23 Oliver, Alexander Capate RN 767156 Voluntary Surrender 5/1/23 Warning with Stipulations Owens, Heather Nicole RN 925454 5/9/23 and Fine Owens, Kami D'lynn LVN 190667 Warning with Stipulations 6/13/23 Ozenne, Denita Denise RN 864541 Remedial Education with Fine 7/5/23 Pabalate, Maria L. LVN 336806 Probated Suspension 5/9/23 Palacios, Michael Andrew RN 923422 Voluntary Surrender 5/19/23 Panturad, Michael RN 601768 Enforced Suspension 5/15/23 Hsmeyer Patino, Damaris Priscilla RN 951055 & LVN 334914 Warning with Stipulations 6/13/23 Payne, Matthew Kirk LVN 319672 Remedial Education 5/15/23 Pendleton, Monique Deidre AP139446 Voluntary Surrender 6/12/23 Penley, Sherry RN 642055 & LVN 147240 Remedial Education with Fine 7/6/23 Pischke, Janet Kathleen RN 847721 Revoked 5/9/23 Plantinga, Christina Marie RN 653580 Remedial Education 7/13/23 Prejean, Nedia LVN 1027159 Warning with Stipulations 6/13/23 Pugh, Jason William PTP AR RN R081793 Warning 7/20/23 Warning with Stipulations Ramirez, Bianca RN 939516 6/13/23 and Fine Regan, Bernadette RN 830457 Remedial Education 7/14/23 Katherine 5/9/23 Reinhart, Angela Ruth RN 983567 & LVN 170059 Probated Suspension Name
19
License Numbers
Discipline
continued on next page
DISCIPLINARY ACTION - cont. from prev. pg. Name Rice, Tawhanna
License Numbers
Discipline
RN 628901 & LVN 150870 Voluntary Surrender Warning with Stipulations, Richardson, Kristine Nicole RN 925307 Deferred Warning with Stipulations Rimkus, Joanne RN 784118 and Fine AP133229, RX 22454 & RN Roberts, Johnny Don Warning with Stipulations 739656 Robinson, Denise Nicole AP117912 & RN 768152 Remedial Education Rodgers, Lindi Allyson LVN 346797 Probated Suspension Rodriguez, Laura Garcia RN 759942 & LVN 203828 Probated Suspension Roe, Jeanne Marie LVN 336058 Revoked Rogers, Gina L. RN 628908 Enforced Suspension Rogers, Robert Allen LVN 204078 Reprimand with Stipulations Roselle-Nauman, Melanie RN 653432 Warning with Stipulations Rubaba, Farrellin Iyatunde RN 883717 Revoked Runnels, Jessica Tyler RN 820695 Reprimand with Stipulations Ryno, Courtney Rochelle LVN 342617 Probated Suspension Sadler, Philip Jason RN 829972 Warning with Stipulations Saenz, Dylan Sauceda LVN 316503 Warning with Stipulations Saldana, Patricia Alvarez RN 578341 Warning with Stipulations Salinas, Amber M. LVN 199971 Revoked Sandoval, Sonya Vanisu RN 813114 Warning with Stipulations Santivanez, Erika Raquel RN 906489 Warning with Stipulations Scypion, Jessica Ann LVN 320231 Warning with Stipulations Seitzer, Ashley Nicole AP123829 & RN 744205 Probated Suspension AP116147, RX 7936 & RN Shaili, Meenakshi Reprimand with Stipulations 744909 Shamburger, Jazmine LVN 331529 Revoked Jonelle Singletary, Michelle Renee LVN 209241 Reprimand with Fine Singleton, Waynett Jean RN 931516 Revoked Sizemore, Janie LVN 307039 Remedial Education Smith, Andrea Kay LVN 185243 Remedial Education with Fine Smith, Margaret Molinar LVN 205824 Revoked Sowder, Brandy Michelle RN 769760 Revoked Springer, Sonya RN 886380 Remedial Education, Deferred Stacy, Lori RN 637179 Voluntary Surrender Stafford, Lora Jean RN 737719 Revoked Stanley, Jennifer Lynn RN 729922 & LVN 186673 Reprimand with Stipulations Warning with Stipulations, Stone, Hannah Reagan RN 973530 Deferred Stone, Robbie Marie RN 794511 Warning with Stipulations Stout, Deborah Storm RN 802280 Enforced Suspension Stowe, Billie Jean RN 669029 Voluntary Surrender Sudds, Irene Marie RN 787029 & LVN 219590 Warning with Stipulations Sullivan, Courtney RN 968421 Remedial Education Suzanne Swails, Ericka Nichelle RN 1075840 Warning Thibodeau, Shawn RN 593024 Reprimand with Stipulations Tidwell, Lorrie J. LVN 109999 Warning with Stipulations AP111708, RX 4516 & RN Tomasek, Stephanie Warning with Stipulations 637471 AP116603, RX 8294 & RN Turner, Joyce Elaine Warning with Stipulations 738810 Ugwu, Queen Ezinne LVN 221483 Enforced Suspension Unang, Samuel RN 864117 Warning with Stipulations Valdespino, Robert Joel AP111863 & RN 687150 Probated Suspension Varner, Mark Jason RN 760804 Remedial Education with Fine
Action Date 6/21/23 5/9/23 7/20/23 5/9/23 5/10/23 6/13/23 6/13/23 5/9/23 7/10/23 5/9/23 6/13/23 5/9/23 6/13/23 6/13/23 6/13/23 6/13/23 6/13/23 5/9/23 7/20/23 7/20/23 6/13/23 6/13/23
Name Verstuyft, Loretta Villarreal Jr., Armando Vondracek, Mercedes Dawn Walker, Jerrye Darlyn Walker, Martha Jane Wangumo, Eva M. Ward, Robert Andrew Watson, Eliana Yvonne Portillo White, Gavin Michael Willett, Addye Melissa Williams, Dovie Lavette Williams, Katina Sherrell Williford, Karlie Mae Winkleman, Leslie Diane Wood, Madalyn Elaine Wools, Luetta Ellen Wright, Amy Lyn
RN 508687 Warning with Stipulations RN 722669 & LVN 182266 Warning with Stipulations
Action Date 5/9/23 7/20/23
RN 788187
Remedial Education
5/16/23
LVN 148121 AP140145 & RN 954819 RN 868511 RN 845732
Remedial Education with Fine Remedial Education with Fine Limited License Revoked
7/5/23 7/5/23 6/22/23 7/20/23
RN 961016
Warning with Stipulations
7/20/23
RN 1015875 LVN 310150 RN 725088 LVN 322965 RN 817208 RN 749920 RN 938850 RN 982260 RN 841324
Remedial Education Probated Suspension Reprimand with Stipulations Remedial Education with Fine Voluntary Surrender Remedial Education Warning with Stipulations Probated Suspension Revoked
6/12/23 5/9/23 7/20/23 5/24/23 7/12/23 6/13/23 5/9/23 6/13/23 5/9/23
License Numbers
Discipline
Abbreviations in the Notice of Disciplinary Action Section PTP Privilege to Practice in Texas associated with the indicated state and license. RX
Prescription Authorization
6/13/23 5/9/23
Statistical information
7/20/23 6/13/23 6/30/23 6/20/23 6/13/23 7/20/23 5/17/23 5/31/23 5/9/23 6/13/23
The 244 disciplinary actions reported in this Bulletin represent only 0.045% of nurses who are currently licensed to practice in the State of Texas. As of August 31, 2023, 99.72% 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.
Do You Want to Receive an Email Alert When the Bulletin Goes Online?
6/13/23 6/13/23 7/20/23 5/2/23 5/9/23
The Texas Board of Nursing (BON) discontinued mailing the Texas Board of Nursing Bulletin (Bulletin). Nurse employers, other boards of nursing, and any interested individuals who would like to receive an email alert when the newsletter is posted may also do so when the Bulletin is posted online. The only requirements necessary to receive an alert when the Bulletin is posted is to notify the Board that you would like to receive an alert when the Bulletin is posted. Note: all nurses who have established nurse portal accounts will be sent notice of bulletins using the email address associated with the account. If you would like to be added to the electronic notification list for all issues of the newsletter, please send an email to bruce. holter@bon.texas.gov. In the Subject Line for the email, write Add Me to the Bulletin List. No further information is required. The email address that you provide will only be used to notify you when the newsletter has been posted.
7/26/23 6/13/23 7/20/23 5/9/23 7/20/23 5/9/23 7/11/23 6/13/23 5/9/23 5/30/23
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Texas Prescription Monitoring Program Integration Funding The Texas Prescription Monitoring Program (PMP) is used to collect and monitor prescription data for all Schedule II, III, IV, and V Controlled Substances dispensed by a pharmacy in Texas or to a Texas resident from a pharmacy located in another state. The PMP also provides a database for monitoring patient prescription history for practitioners and the ordering of Schedule II Texas Official Prescription Forms. As of March 2020, prescribers have been required to check a patient’s PMP history before dispensing or prescribing opioids, benzodiazepines, barbiturates, or carisoprodol. The reporting requirement applies to all Schedule II, III, IV, and V controlled substances. Currently, prescribers are encouraged to check the PMP to help eliminate duplicate and overprescribing of controlled substances, as well as to obtain critical controlled substance history information. In addition to the existing PMP functionality, NarxCare, an advanced analytics and patient support tool enhancement to the PMP, will aggregate and analyze prescription information from providers and pharmacies and present visual, interactive information, as well as advanced analytic insights, machine learning risk scores and more to help physicians, pharmacists and care teams to provide better patient safety and outcomes. NarxCare also provides tools and resources that support patients’ needs and connects them to treatment, when appropriate. Bamboo Health’s PMP Gateway solution helps healthcare providers integrate the PMP data and NarxCare analysis into approved Electronic Health Records (EHRs). This integration eliminates the need for prescribers to navigate to the Texas PMP website, log in, and enter their patient’s information. This workflow helps save 4.2 minutes per patient encounter and supports providers in meeting mandatory use laws associated with the PMP. With this enhancement, healthcare providers will have access to all features and functions of NarxCare with a consistent look and feel for users who access the solution through the PMP web portal. The Texas State Board of Pharmacy has announced statewide support to help healthcare providers by funding the licensing fees associated with the integration service for those providers that elect to connect their EHR to PMP Gateway effective September 1, 2023. If your organization is interested in integrating your EHR with the state PMP, authorized decision makers should submit an integration request by creating an account on Bamboo Health’s Customer Connect Portal. Additional information about the Texas Prescription Monitoring Program Statewide Integration can be found on the Texas State Board of Pharmacy Texas Prescription Monitoring Program website.
Certification of Medical Condition and Mental Status for Guardianship Proceedings The medical condition and mental state of a person proposed for guardianship must be considered by the courts in a guardianship proceeding. Historically, only a licensed physician was eligible to complete a physician’s certificate of evaluation for the individual who was proposed for guardianship. Effective September 1, 2023, APRNs are now authorized to examine a person to determine whether that person is incapacitated for the purpose of guardianship proceedings. The Texas Estates Code permits judges to consider a letter or certificate of evaluation from an Advanced Practice Registered Nurse (APRNs) as part of a guardianship proceeding. As noted in Section 1101.1011 of the Estates Code, physician delegation is required for an APRN to provide this service. Additionally, the Estates Code requires that both the APRN and their delegating physician sign the letter or certificate regarding a proposed ward’s incapacity that is based on an examination by the APRN. The letter or certificate of evaluation must include all elements required by Texas law. APRNs who choose to provide this service should review Chapters 1101, 1102, and 1202 of the Estates Code to be certain the information they provide complies with these requirements.
21
Mark Majek Shaped the Regulation of Nursing in Texas for More Than Three Decades Mark Majek, MA, PHR, SHRM-CP, Director of Operations for the Texas Board of Nursing (BON or Board) has appeared in the BON Bulletin a few times in the past three decades. When Mr. Majek first began working at the Board 36 years ago, the agency only licensed Registered Nurses (RNs), agency staff were traveling to test sites in a crusty old station wagon to administer the RN examinations, and the entire agency staff could fit in a small conference room. Since that time, the agency has grown to more than 120 staff members, with almost half a million nurses licensed by the Board. Mr. Majek had many roles including supervision of Customer Service, Information Technology, Licensing, and Human Resources. His wealth of knowledge and experience was further tested as he went on to shape nursing regulation at the national level through his work for the National Council of State Boards of Nursing (NCSBN). His accomplishments included serving two terms as Area III Director-at-Large; Special Services Division Group, 1994; Delegate Assembly Page, 1995-2000; Licensure Verification Task Force, 1995- 1997; Licensure Verification Task Force, Chair, 1996-1997; Information System Users Group, 1998-1999; Phase II User Group Nursys, 1999-2000; Nursys Advisory Panel, 2000-2001; NCSBN Board of Directors, Area III Director, 2001-2005; Member Board Leadership Development Advisory Panel, 2006-2007; Finance Committee, 2008-2011; Leadership Succession Committee, 2012-2015; and Bylaws Committee, Chair, 2015-2017. Mr. Majek’s leadership roles at the NCSBN drew from his experiences in Texas using a proprietary licensing system developed and refined in house. His leadership roles at the national level are a testament to his commitment to improving the regulation of nursing, both in Texas and for the many member jurisdictions served by NCSBN. With his many years of experience in nursing regulation, staff interviewed Mr. Majek concerning his time at the Board. 1. In your time at the Board, licensure for Texas nurses has changed significantly for nurses in Texas. What changes have caused the most impact to nursing in Texas since you became a staff member at the Board of Nursing? Mandatory reporting and criminal background checks had the most significant impact on the Texas Board of Nursing (BON). Not only from a public protection perspective but also from increased staffing and resources at the BON. As complaints grew every year, we added staff and resources to match the volume. It took eight years to complete the background checks on all current licensees. 2. You have served in various roles at the National Council of State Boards of Nursing in your time working for the Board of Nursing. What insights did you come away with while working at the National level to shape the regulation of Nursing? Although our regulation is state based, we’re not in a regulatory silo and we benefit from sharing state knowledge among members. The State of Texas was a huge beneficiary of national resources with the implementation of the national licensure compact, the development of Nursys database and the implementation of the Optimal Regulatory Board System. This cooperation allowed for national public protection and saved the citizens of Texas several million dollars. 3. After seeing what is taking shape at the national level for nursing regulation, what should Texas nurses expect to see in the future for the profession of nursing? Increase national and international cooperation among states, provinces and countries as the regulatory walls tumble with the increased use of technology both with telemedicine and the development of artificial intelligence. 4. What are the best changes you have seen in the regulation of nursing during your time at the Board? What are the worst? The Best: The development of Nursys, the national database that allows nurses and the public to verify licensure seamlessly and effectively. The Worst: Although we faced challenges especially during the pandemic, I never faced a difficult situation that didn’t make the BON stronger and more relevant to public protection. 5. What are you the proudest of in your time with the Board? The ability to lower fees for our customers several times and maintain the lowest renewal fees in the nation. I believe public protection is both health related and showing fiscal responsibility. 6. What will you miss the most? My colleagues and customers who taught me humility and that kindness does matter, even as a regulator! 22
Texas Peer Assistance Program for Nurses Fall 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. TPAPN is looking for more Peer Support Partners. Peer Support Partner Information Sessions are currently offered monthly by TPAPN so you can learn more about the fundamental role of the Peer Support Partner. The next information sessions are scheduled from noon to 1 PM central time on:
October 17, 2023
November 14, 2023
December 12, 2023
A prospective peer support partner must attend an information session as a prerequisite to initiating training to become a peer support partner. Registration links for the information sessions and other education and training opportunities are located on the TPAPN website (TPAPN.org). A nurse with issues related to substances or mental health that might impact nursing practice may self-report to TPAPN. A person may report a nurse to TPAPN when there is a suspicion that a nurse may have a substance use or mental health condition and the nurse has not had a nursing practice violation. The TPAPN referral form is on the TPAPN website. A nurse who has committed a practice violation and is impaired or suspected of being impaired must be reported to the Board of Nursing (BON). The BON website contains links to complaint forms under Discipline & Complaints – How to File a Complaint. Board of Nursing Contact Information
Texas Board of Nursing Meeting Schedule
MAIN NUMBER...........................................................(512) 305-7400 FAX.............................................................................(512) 305-7401 -- 24-hour Access -- License Verification -- General Information
2023 Board Meeting Dates
October 19-20
ENFORCEMENT............................................................(512) 305-6838 -- Complaint and Disciplinary Action Inquiries -- Violations of NPA and Rules and Regulations -- Monitoring of Disciplined RNs and LVNs
2023 Eligibility and Disciplinary Committee Meeting Dates
OPERATIONS CUSTOMER SERVICE..............................................(512) 305-6809 -- License Renewals, Endorsement, Examination, or Continuing Education for Nurses...........Licensing@bon.texas.gov
November 14 December 12
PROFESSIONAL AND VOCATIONAL NURSING ADVANCED PRACTICE............................................(512) 305-6843 -- APRN Application and Prescriptive Authority Procedures....................aprn@bon.texas.gov
For meeting times and locations, visit the Board of Nursing website.
NURSING EDUCATION...........................................(512) 305-6816 NURSING PRACTICE...............................................(512) 305-6802 -- Nursing Practice Issues -- Legislation
* - The Board meeting scheduled for October 19-20, 2023, may be streamed online. Meeting access infomation will be posted at: www.bon.texas.gov
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Protecting Your Patients and Your Practice, Nursing Jurisprudence and Ethics Workshop Schedule 2024 Each calendar year, Board staff provide five workshops, educating nurses and stakeholders about nursing jurisprudence and ethics. The purpose of these workshops is to provide registered nurses, licensed vocational nurses, and advanced practice registered nurses with information on the current nursing licensure laws that serve as the foundation for the nurses’ practice in the State of Texas. Workshop participation will contribute to the nurse’s ability to know and conform with the Texas Nursing Practice Act and the Board’s Rules & Regulations, which in turn will promote and protect the welfare of the public. These workshops offer continuing nursing education (CNE) credits to meet the Nursing Jurisprudence and Nursing Ethics Board Rule 216.3(g) requirement or as a requirement for Board order. In 2024, Board staff will be offering four virtual platform deliveries and one in-person delivery. The dates of those offerings are:
• Wednesday, November 8, 2023 – Virtual, Microsoft Teams Webinar • Wednesday, March 6, 2024 – Virtual, Microsoft Teams Webinar • Thursday, June 20, 2024 – In-person, Barbara Jordan State Office Building, 1601 Congress Avenue, Room 2.013, Austin, TX 78701 • Wednesday, August 7, 2024 – Virtual, Microsoft Teams Webinar • Wednesday, September 25, 2024 – Virtual Microsoft Teams Webinar • Wednesday, November 6, 2024 – Virtual Microsoft Teams Webinar As more registration details are available, the information will be posted on the Texas Board of Nursing CNE Course Catalog page here. 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. 24
