Part 12.
BOARD OF VOCATIONAL NURSE EXAMINERS
Chapter 233.
EDUCATION
Subchapter A. DEFINITIONS
22 TAC §233.1
The Board of Vocational Nurse Examiners proposes amendment
of §233.1, relating to Definitions. The amendment will address terminology
revisions due to the adoption of the new
Differentiated
Entry Level Competencies for Graduates of Texas Nurses
, February 2002.
Terrie L. Hairston, Executive Director, has determined that for the first
five year period the rule is in effect, there will be no fiscal implication
for state or local government as a result of enforcing or administering the
rule.
Ms. Hairston has also determined that for each year of the first five years
the rule is is in effect the public benefit anticipated as a result of enforcing
the rule will be consistency in the rules. There will be no effect on small
businesses. There is no anticipated economic costs to persons who are required
to comply with the rule as proposed.
Comments may be submitted to Terrie L. Hairston, Executive Director, Board
of Vocational Nurse Examiners, 333 Guadalupe, Suite 3-400, Austin, Texas 78701.
The amendment is proposed under Chapter 302, Texas Occupations
Code, Subchapter D, §302.151(b), which provides the Board of Vocational
Nurse Examiners with the authority to make such rules and regulations as may
be necessary to carry in effect the purpose of the law.
No other statute, article or code will be affected by this proposal.
§233.1.Definitions.
The following words and terms, when used in this chapter, shall have
the following meanings, unless the context clearly indicates otherwise:
(1) - (15)
(No change.)
(16)
Differentiated Entry Level Competencies--the
expected educational outcomes to be demonstrated by nursing students at the
time of graduation as published in
Differentiated
Entry Level Competencies of Graduates of Texas Nursing Programs
, February
2002, as amended.
(17)
[
(18)
[
(19)
[
[(19)
Essential Competencies--the expected
educational outcomes to be demonstrated by nursing students at the time of
graduation as published in Nursing Education Advisory Committee, Report Volume
I, Essential Competencies of Texas Graduates of Education Programs in Nursing,
March 1993, as amended.]
(20) - (42)
(No change.)
This agency hereby certifies that the proposal has been
reviewed by legal counsel and found to be within the agency's legal authority
to adopt.
Filed with the Office of
the Secretary of State on July 3, 2002.
TRD-200204230
Terrie Hairston, RN, CHE
Executive Director
Board of Vocational Nurse Examiners
Earliest possible date of adoption: August 18, 2002
For further information, please call: (512) 305-7653
22 TAC §233.58
The Board of Vocational Nurse Examiners proposes an amendment
to §233.58, relating to Vocational Nursing Education Standards. The amendment
will address terminology revisions due to the adoption of the new
Differentiated Entry Level Competencies for Graduates of Texas Nurses
,
February 2002.
Terrie L. Hairston, Executive Director, has determined that for the first
five year period the rule is in effect, there will be no fiscal implication
for state or local government as a result of enforcing or administering the
rule.
Ms. Hairston has also determined that for each year of the first five years
the rule is in effect the public benefit anticipated as a result of enforcing
the rule will be consistency in the rules. There will be no effect on small
businesses. There is no anticipated economic costs to persons who are required
to comply with the rule as proposed.
Comments may be submitted to Terrie L. Hairston, Executive Director, Board
of Vocational Nurse Examiners, 333 Guadalupe, Suite 3-400, Austin, Texas 78701.
The amendment is proposed under Chapter 302, Texas Occupations
Code, Subchapter D, §302.151(b), which provides the Board of Vocational
Nurse Examiners with the authority to make such rules and regulations as may
be necessary to carry in effect the purpose of the law.
No other statute, article or code will be affected by this proposal.
§233.58.Curriculum Requirements.
(a)
(No change.)
(b)
Framework. The philosophy shall be the basis for curriculum
development and shall reflect the purpose of the organization, faculty beliefs,
and
education
[
(c)
Design and Implementation. The curriculum shall be designed
and implemented to prepare students to demonstrate the
Differentiated
Entry Level
[
(d) - (i)
(No change.)
This agency hereby certifies that the proposal has been reviewed
by legal counsel and found to be within the agency's legal authority to adopt.
Filed with the Office of
the Secretary of State on July 3, 2002.
TRD-200204229
Terrie Hairston, RN, CHE
Executive Director
Board of Vocational Nurse Examiners
Earliest possible date of adoption: August 18, 2002
For further information, please call: (512) 305-7653
22 TAC §240.13
(Editor's note: The text of the following section proposed for
repeal will not be published. The section may be examined in the offices of
the Board of Vocational Nurse Examiners or in the Texas Register office, Room
245, James Earl Rudder Building, 1019 Brazos Street, Austin.)
The Board of Vocational Nurse Examiners proposes
the repeal of §240.13, concerning minimum procedural standards during
peer review relating to peer review procedures. This rule will be proposed
with new language.
Terrie L. Hairston, Executive Director, has determined that for the first
five year period the repeal is in effect, there will be no fiscal implication
for state or local government as a result of enforcing or administering the
repeal.
Mrs. Hairston has also determined that for each year of the first five
years the repeal is in effect the public benefit anticipated as a result of
enforcing the repeal will be consistency in the rules. There will be no effect
on small businesses. There is no anticipated economic costs to persons who
are required to comply with the repeal as proposed.
Comments may be submitted to Terrie L. Hairston, Executive Director, Board
of Vocational Nurse Examiners, 333 Guadalupe, Suite 3-400, Austin, Texas 78701.
The repeal is proposed under Chapter 302, Texas Occupations Code,
Subchapter D, §302.151(b), which provides the Board of Vocational Nurse
Examiners with the authority to make such rules and regulations as may be
necessary to carry in effect the purpose of the law.
No other statute, article or code will be affected by this proposal.
§240.13.Minimum Procedural Standards During Peer Review.
This agency hereby certifies that the proposal has been
reviewed by legal counsel and found to be within the agency's legal authority
to adopt.
Filed with the Office of
the Secretary of State on July 3, 2002.
TRD-200204231
Terrie Hairston, RN, CHE
Executive Director
Board of Vocational Nurse Examiners
Earliest possible date of adoption: August 18, 2002
For further information, please call: (512) 305-7653
22 TAC §240.13
The Board of Vocational Nurse Examiners proposes new §240.13,
relating to Incident-Based Nursing Peer Review. The proposed new language
will replace the present language minimum procedural standards during peer
review.
Terrie L. Hairston, Executive Director, has determined that for the first
five year period the rule is in effect, there will be no fiscal implication
for state or local government as a result of enforcing or administering the
rule.
Mrs. Hairston has also determined that for each year of the first five
years the rule is in effect the public benefit anticipated as a result of
enforcing the rule will be consistency in the rules. There will be no effect
on small businesses. There is no anticipated economic costs to persons who
are required to comply with the rule as proposed.
Comments may be submitted to Terrie L. Hairston, Executive Director, Board
of Vocational Nurse Examiners, 333 Guadalupe, Suite 3-400, Austin, Texas 78701.
The new rule is proposed under Chapter 302, Texas Occupations
Code, Subchapter D, §302.151(b), which provides the Board of Vocational
Nurse Examiners with the authority to make such rules and regulations as may
be necessary to carry in effect the purpose of the law.
No other statute, article or code will be affected by this proposal.
§240.13.Incident-Based Nursing Peer Review.
(a)
Minimum Due Process
(1)
The provisions of this subsection apply:
(A)
to peer review for licensed vocational nurses (LVNs). Any
reference to "nurse" is a reference to LVNs. See Texas Occupations Code §303.001(1)
- (3).
(B)
only to peer review conducted for purpose of evaluating
if an LVN has engaged in unacceptable nursing practice.
(2)
Texas Occupations Code §303.001(5), states, "Peer
review means the evaluation of nursing services, the qualifications of nurses,
the quality of patient care rendered by nurses, the merits of complaints concerning
nurses and nursing care, and determinations or recommendations regarding complaints".
The peer review process is one of fact finding, analysis and study of events
by nurses in a climate of collegial problem solving focused on obtaining all
relevant information about an event. Once a decision is made that a nurse
is subject to peer review, Texas Occupations Code §303.002(e) provides
that the nurse is entitled to minimum due process. The purpose of this rule
is to define minimum due process, to provide guidance to facilities in developing
peer review plans, to assure that nurses have knowledge of the plan, and to
provide guidance to the peer review committee in its fact finding process.
(3)
A facility conducting peer review shall have written policies
and procedures that, at a minimum, address:
(A)
level of participation of nurse or nurse's representative
at peer review proceeding beyond that required by paragraph (4)(F) of this
subsection (e.g., nurse's or representative's ability to question witnesses);
(B)
confidentiality and safeguards to prevent impermissible
disclosures including written agreement by all parties to abide by Texas Occupations
Code §303.006 and §303.007;
(C)
handling of cases involving nurses suspected of having
problems with chemical dependency or mental illness in accordance with the
Texas Occupations Code §302.402(9) and §302.402(12);
(D)
effective date of changes to the policies which in no event
shall apply to peer review proceedings initiated before the change was adopted
unless agreed in writing by the nurse being reviewed.
(4)
In order to meet the minimum due process required by the
Texas Occupations Code chapter 303, the Nursing Peer Review Committee must:
(A)
comply with the membership and voting requirements as set
forth in Texas Occupations Code §303.003(a) - (d);
(B)
exclude from the committee any person or persons with administrative
authority for personnel decisions directly relating to the nurse;
(C)
provide written notice to the nurse in person or by certified
mail at the last known address the nurse has on file with the facility that
his/her practice is being evaluated, that the peer review committee will meet
on a specified date not sooner than 21 calendar days and not more than 45
calendar days from date of notice, unless otherwise agreed upon by the nurse
and peer review committee. Said notice must include a written copy of the
peer review plan, policies and procedures;
(D)
include in the written notice:
(i)
a description of the event(s) to be evaluated in sufficient
detail to inform the nurse of the incident, circumstances and conduct (error
or omission), including date(s), time(s), location(s), and individual(s) involved.
The patient/client shall be identified by initials or number to the extent
possible to protect confidentiality but the nurse shall be provided the name
of the patient/client;
(ii)
name, address, telephone number of contact person to receive
the nurse's response; and
(iii)
a copy of this rule and a copy of the facility's peer
review plan, policies and procedures.
(E)
provide the nurse the opportunity to review, in person
or by attorney, the documents concerning the event under review, at least
15 calendar days prior to appearing before the committee;
(F)
provide the nurse the opportunity to:
(i)
submit a written statement regarding the event under review;
(ii)
call witnesses, question witnesses, and be present when
testimony or evidence is being presented;
(iii)
be provided copies of the witness list and written testimony
or evidence at least 48 hours in advance of proceeding;
(iv)
make an opening statement to the committee;
(v)
ask questions of the committee and respond to questions
of the committee; and
(vi)
make a closing statement to the committee after all evidence
is presented;
(G)
conclude its review no more than 14 calendar days from
the peer review proceeding;
(H)
provide written notice to the nurse in person or by certified
mail at the last known address the nurse has on file with the facility of
the findings of the committee within ten calendar days of when the committee's
review has been completed; and
(I)
permit the nurse to file a written rebuttal statement within
ten calendar days of the notice of the committee's findings and make the statement
a permanent part of the peer review record to be included whenever the committee's
findings are disclosed.
(5)
Nurse's Right To Representation. A nurse shall have a right
of representation as set out in this section. The rights set out in this section
are minimum requirements and a facility may allow the nurse more representation.
The peer review process is not a legal proceeding; therefore, rules governing
legal proceedings and admissibility of evidence do not apply and the presence
of attorneys is not required. The nurse has the right to be accompanied to
the hearing by a nurse peer or an attorney. Representatives attending the
peer review hearing must comply with the facility's peer review policies and
procedures regarding participation beyond conferring with the nurse. If either
the facility or nurse will have an attorney or representative present at the
peer review hearing in any capacity, the facility or nurse must notify the
other at least seven calendar days before the hearing that they will have
an attorney or representative attending the hearing and in what capacity.
Notwithstanding any other provisions of these rules, if an attorney representing
the facility or peer review committee is present at the peer review hearing
in any capacity, including serving as a member of the peer review committee,
the nurse is entitled to "parity of participation of counsel." "Parity of
participation of counsel" means that the nurse's attorney is able to participate
to the same extent and level as the facility's attorney; e.g., if the facility's
attorney can question witnesses, the nurse's attorney must have the same right.
(6)
Confidentiality of information presented to and/or considered
by the peer review committee shall be maintained and not disclosed except
as provided by Texas Occupations Code §303.006 and §303.007. Disclosure/discussion
by a nurse with the nurse's attorney is proper because the attorney is bound
to the same confidentiality requirements as the nurse.
(7)
In evaluating a nurse's conduct, the committee shall review
the evidence to determine the extent to which any deficiency in care by the
nurse was the result of deficiencies in the nurse's judgment, knowledge, training,
or skill rather than other factors beyond the nurse's control. A determination
that a deficiency in care is attributable to a nurse must be based on the
extent to which the nurse's conduct was the result of a deficiency in the
nurse's judgment, knowledge, training, or skill.
(8)
If a peer review committee finds that a nurse has engaged
in conduct reportable to the Board of Vocational Nurse Examiners, the committee's
report shall include:
(A)
a description of any corrective action taken against the
nurse and
(B)
a statement as to whether the committee recommends that
formal disciplinary action be taken against the nurse.
(9)
Texas Occupations Code chapter 303, requires that peer
review be conducted in good faith. A nurse who knowingly participates in peer
review in bad faith is subject to disciplinary action by the Board under the
Texas Occupations Code §302.402. Examples of bad faith are taking action
against a nurse without providing the nurse the rights provided by these rules
or taking action based on personal animosity towards the nurse.
(10)
A nurse whose practice is being evaluated may properly
choose not to participate in the proceeding after the nurse has been notified
under paragraph (4)(C) of this subsection. Texas Occupations Code §303.002(d)
prohibits nullifying by contract any right a nurse has under the peer review
process.
(11)
The Chief Nursing Officer (CNO) of a facility is responsible
for knowing the requirements of this Rule and for taking reasonable steps
to assure that peer review is implemented and conducted in compliance with
this Rule. The CNO is the registered nurse who is administratively responsible
for nursing services.
(b)
Effect of LVN Reporting to Peer Review Committee. If a
registered nurse reports a nurse to a nursing peer review committee for conduct
that the nurse has a duty to report to the Board, the report to the committee
will satisfy the nurse's duty to report to the Board provided that the following
conditions are met:
(1)
The peer review committee shall report the nurse to the
Board, if it finds the nurse engaged in reportable conduct. If the peer review
committee finds that the conduct constitutes a minor incident as defined by §240.11
of this title (relating to Reporting of Minor Incidents), it shall report
in accordance with the requirements of that rule;
(2)
The reporting nurse shall be notified of the peer review
committee's findings and shall be subject to Texas Occupations Code §303.006;
and
(3)
the reporting nurse accepts in good faith the findings
of the peer review committee.
This agency hereby certifies that the proposal has been
reviewed by legal counsel and found to be within the agency's legal authority
to adopt.
Filed with the Office of
the Secretary of State on July 3, 2002.
TRD-200204232
Terrie Hairston, RN, CHE
Executive Director
Board of Vocational Nurse Examiners
Earliest possible date of adoption: August 18, 2002
For further information, please call: (512) 305-8101
Chapter 661.
GENERAL RULES OF PROCEDURES AND PRACTICES
Subchapter A. THE BOARD
(16)
] Director or Coordinator--denotes
the nurse executive directly in charge of and responsible for the program.
(17)
] Director Affidavit--an official
board form containing an approved nursing program's curriculum components
and hours, a statement attesting to an applicant's qualifications for vocational
nurse licensure in Texas, the official school seal and the signature of the
nursing program director.
(18)
] Entry-level Competencies--describe
the desirable behaviors exhibited by graduates of vocational nursing programs
and are in accord with statutes governing nursing care and are based on the
Differentiated Entry Level
[
Essential
] Competencies.
Subchapter D. VOCATIONAL NURSING EDUCATION STANDARDS
educational
] concepts. Terminal learning
objectives derived from the philosophy shall be representative of the [
Essential
]
Differentiated Entry Level
Competencies for preparation
of a vocational nurse graduate. Level and course objectives shall be stated
in behavioral terms and shall serve as the mechanism for student progression.
The conceptual framework shall define the internal and external influences
impacting vocational nursing education and shall identify the
educational
[
education
] method and focus.
Essential
] Competencies. The curriculum design
shall allow for flexibility to incorporate current nursing education theories
and the implications of current developments in health care and health care
delivery to assist graduates in meeting professional, legal, and societal
expectations. Educational mobility shall also be a consideration in curriculum
design.
Chapter 240.
PEER REVIEW AND REPORTING
Part 29.
TEXAS BOARD OF PROFESSIONAL LAND SURVEYING