Part 11.
BOARD OF NURSE EXAMINERS
Chapter 215.
NURSE EDUCATION
22 TAC §§215.1 - 215.13
The Board of Nurse Examiners for the State of Texas adopts
the repeal of current 22 TAC §§215.1 - 215.13 without changes to
the proposal as published in the May 16, 2003, issue of the
Texas Register
(28 TexReg 3887). These sections concern Nurse Education
and are being repealed concomitant with the adoption of new §§215.1
- 215.13. This repeal is being done pursuant to the Board's rule review published
in the April 5, 2002, issue of the
Texas Register
(27 TexReg 2845).
The Texas Government Code requires that each rule adopted by an agency
after September 1, 1997 be reviewed within four years of the date it was adopted.
The purpose of the review is to make a determination if the reason for adopting
the rule continues to exist. The Board also received feedback from the education
community that the current provisions of the chapter were too burdensome.
The current Chapter 215 has not been reviewed in its entirety since the repeal
and adoption of a new chapter in December 1998. The chapter change became
effective September 1999.
The Board's Advisory Committee on Education (ACE) began the process of
discussing revisions to Chapter 215 in February 2002. The committee has now
completed the review of the chapter. The committee and staff worked diligently
to address the concerns expressed by the education community, specifically
that sections of the chapter were too prescriptive. The committee and staff
were resolved to create a workable solution that would address input from
the nursing education programs. Consensus was reached in identifying an abbreviated
process for meeting the intent of the proposed new chapter. This process would
hold nursing programs accountable without compromising the purpose and function
of the Board, which is to protect the citizens of Texas. The abbreviated process
will reduce the work required by nursing programs when making major curriculum
changes, as well as when expanding the program to other sites (DEI). Other
changes to the chapter included the addition of clarifying comments throughout
the chapter and deletion of areas that were no longer meaningful.
No comments were received addressing the repeal of this chapter.
The repeal is adopted pursuant to Texas Occupations Code §301.151
which authorizes the board to propose rules necessary for the performance
of its duties and §301.157 which requires the Board to prescribe rules
for its programs of study and accreditation.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of
the Secretary of State on July 28, 2003.
TRD-200304575
Katherine Thomas
Executive Director
Board of Nurse Examiners
Effective date: August 17, 2003
Proposal publication date: May 16, 2003
For further information, please call: (512) 305-6823
22 TAC §§215.1 - 215.13
The Board of Nurse Examiners for the State of Texas adopts
new §§215.2 - 215.4 and §§215.8 - 215.10 with changes
to the proposed text as published in the May 16, 2003, issue of the
The Texas Government Code requires that each rule adopted by an agency
after September 1, 1997, be reviewed within four years of the date it was
adopted. The purpose of the review is to make a determination if the reason
for adopting the rule continues to exist. The Board also received feedback
from the education community that the current provisions of the chapter were
too burdensome. The current Chapter 215 has not been reviewed in its entirety
since the repeal and adoption of a new chapter in December 1998. The chapter
change became effective September 1999.
The Board's Advisory Committee on Education (ACE) began the process of
discussing revisions to Chapter 215 in February 2002. The committee completed
the review of the chapter. The committee and staff worked diligently to address
the concerns expressed by the education community, specifically that sections
of the chapter were too prescriptive. Committee members also discussed how
the current chapter impacted their programs. There were three areas of the
chapter that received the most discussion. The first area was the section
which requires programs to submit major curriculum changes to board staff
for approval. The second area of most concern was the process required to
initiate a distance education site. Board staff shared concerns regarding
deletion of these two requirements and provided a compilation of data for
ACE to consider before making revisions to the chapter. The committee and
staff were resolved to create a workable solution that would address input
from the nursing education programs. Consensus was reached in identifying
an abbreviated process for meeting the intent of the chapter. This process
would hold nursing programs accountable without compromising the purpose and
function of the Board, which is to protect the citizens of Texas. The abbreviated
process for fully accredited programs will reduce the work required by nursing
programs when making major curriculum changes, as well as when expanding the
program to other sites (DEI). Also, DEIs would no longer have individual pass
rates, but will be included in the program's general pass rate. Finally, the
board will issue a warning to a program when the pass rate of first-time candidates
is less than 80% for two consecutive examination years (§215.4(c)(2)(C))
as opposed to the current chapter's time period of two of the last three examination
years. Other changes to the chapter included the addition of clarifying comments
throughout the chapter and deletion of areas that were no longer meaningful.
In the adoption of this chapter, the Board further deleted redundant language
in §215.3(b)(4) as this language also appears in §215.3(d)(3). The
Board also corrected grammatical and spelling errors.
One comment was received. Dr. Camille Pridgen, a staff member with the
Texas Higher Education Coordinating Board (THECB), filed a response on behalf
of the THECB seeking clarification of the terminology used by the Board in
its rule.
The first area of concern for THECB was that the BNE rules consistently
refer to "clinical learning experiences." Health profession programs in public
community and technical colleges have three types of external learning courses
from which to choose. Typically, associate degree nursing programs will have
clinical experiences but may occasionally have practica using the definitions
found in the THECB Guidelines for Instructional Programs in Workforce Education
and the courses found in the Workforce Education Course Manual. In practice,
associate degree "clinical experience" courses and "practicum" courses are
both used to meet requirements for "clinical learning experiences" as defined
by other agencies. In the rules for Emergency Medical Services, the Texas
Department of Health included a statement that "[p]ractica approved by the
Texas Higher Education Coordinating Board may also be considered a form of
clinical experience under these rules." In nursing programs, "practica" is
generally used for the post-ADN certificates. THECB asked whether there should
be a statement regarding the acceptability of THECB defined "practica" under
the Board's definition of "clinical learning experiences."
The Board determined that THECB's description of "clinical experience"
is consistent with "clinical experience" as addressed in §215.10(f),
Management of Clinical Learning Experiences and Resources. Additionally, the
Board's staff has accepted the "practica" courses when programs have elected
to use them rather than courses described as "clinical experience" and no
problems have been identified. Consequently, Board staff determined that no
change in response to this observation was necessary.
Next, THECB commented that the text in §215.9 discussed the ratio
of clinical: classroom instruction = 3:1. In practice, some of the programs
are using clinical + skills laboratory:lecture = 3:1. Since classroom instruction
includes both lecture and skills labs, what is being done in practice does
not fit the formula. THECB thought it would be helpful to include a statement
regarding where skills labs fit in this formula.
In response to THECB's concern, the class/clinical ratio was not intended
to be a part of this new rule. When calculating the 3:1 clinical/theory ratio,
board staff calculates skills lab time as part of the clinical ratio, if the
lab has a clinical/skills focus and is not used as an extension of classroom
time. As the courses are now formatted to meet THECB requirements, it would
be very difficult, perhaps impossible, for programs to generate enough clinical
hours to meet the 3:1 ratio, if the skills hours were not included as a component
of clinical. The current Board guideline, which was developed prior to the
advent of WECM, conjoins the term "clinical" with "laboratory," and does not
provide a clear direction for expectations regarding the current use of a
skills lab that is associated with a didactic course rather than being included
within a clinical course.
Board staff will provide clarification of the expectations regarding the
focus of a "skills lab" to the existing guideline which explains the 3:1 clinical/theory
ratio.
Finally, THECB observed that the definition for health care professionals
in §215.2(27), specifies someone with a bachelor's degree in a health
care field and gives a partial list of acceptable professions. However, §215.10(f)(5)(D)
of the chapter states that a health care professional can serve as a clinical
preceptor if that person has a bachelor's degree and a current license as
a health care professional. The criterion for having a license appears in §215.10
of the chapter, but not in §215.2. There are many types of health care
professionals who are certified but not licensed.
The Board notes that the Professional Licensing and Certification Division
of the Texas Department of Health lists a variety of allied health disciplines
that may obtain a baccalaureate degree with the option of obtaining licensure,
and/or state, or national certification. The Board believes that adding the
term "certification" could result in a lesser qualified preceptor; therefore,
the current wording to this section of the rule will remain unchanged.
The new sections are adopted pursuant to Texas Occupations Code §301.151
which authorizes the board to propose rules necessary for the performance
of its duties and §301.157 which requires the Board to prescribe rules
for its programs of study and accreditation. This adoption is also made subject
to §2001.039 of the Texas Government Code requiring rule review within
four years of the date of a rule's adoption.
§215.2.Definitions.
Words and terms, when used in this chapter, shall have the following
meanings unless the context clearly indicates otherwise:
(1)
Accredited nursing program
(A)
Board accredited nursing program--A nursing program approved
by the Board of Nurse Examiners for the State of Texas.
(B)
Voluntary accredited nursing program--A nursing program
accredited by a Board approved voluntary nursing accrediting body (i.e. NLNAC,
CCNE).
(2)
Advisory Committee/Board--A group of individuals who provides
input to the Board for consideration.
(3)
Affiliate agency--An agency, other than the governing institution,
which provides learning experiences for students.
(4)
Alternative practice settings--settings which provide opportunities
for clinical learning experiences although their primary function is not the
delivery of health care.
(5)
Articulation--A planned process between two or more educational
systems to assist students to make a smooth transition from one level of education
to another without duplication in learning.
(6)
Baccalaureate degree program for registered nurses--A program
leading to a bachelor's degree in nursing which admits only registered nurses.
(7)
Basic nursing program--An educational unit whose purpose
is to prepare practitioners of professional nursing and whose graduates are
eligible to apply for initial licensure by examination.
(A)
Associate degree program--A program leading to an associate
degree in nursing conducted by an educational unit in nursing within the structure
of a college or university.
(B)
Baccalaureate degree program--A program leading to a bachelor's
degree in nursing conducted by an educational unit in nursing which is a part
of a senior college or university.
(C)
Master's degree program--A program leading to a master's
degree, which is an individual's first professional degree in nursing, and
conducted by an educational unit in nursing within the structure of a senior
college or university.
(D)
Diploma program--A program leading to a diploma in nursing
conducted by a single purpose school usually under the control of a hospital.
(8)
Board--The Board of Nurse Examiners for the State of Texas
composed of members appointed by the Governor for the State of Texas.
(9)
Board survey visit--An on-site visit to a nursing program
by a Board representative for the purpose of evaluating the program of learning
and gathering data to support whether the program is meeting the Board's requirements
as specified in §§215.2 - 215.13 of this chapter (relating to Definitions;
Program Development, Expansion, and Closure; Accreditation; Mission and Goals
(Philosophy and Outcomes); Administration and Organization; Faculty Qualifications
and Faculty Organization; Students; Program of Study; Management of Clinical
Learning Experiences and Resources; Facilities, Resources, and Services; Records
and Reports; and Total Program Evaluation).
(10)
Clinical learning experiences--Faculty-planned and guided
learning activities designed to assist students to meet stated program and
course outcomes and to safely apply knowledge and skills when providing nursing
care to clients across the life span as appropriate to the role expectations
of the graduates. These experiences occur in nursing skills and computer laboratories;
in a variety of affiliate agencies or clinical practice settings including,
but not limited to: acute care facilities, extended care facilities, clients'
residences, and community agencies; and in associated clinical conferences.
(11)
Clinical preceptor--A registered nurse or other licensed
health professional who meets the minimum requirements in §215.10(f)(5)
of this chapter (relating to Management of Clinical Learning Experiences and
Resources), not paid as a faculty member by the governing institution, and
who directly supervises a student's clinical learning experience. A clinical
preceptor facilitates student learning in a manner prescribed by a signed
written agreement between the educational institution, preceptor, and affiliate
agency (as applicable).
(12)
Clinical preceptorship--An organized system of clinical
learning experiences which allows a nursing student, under the direction of
a faculty member, to attain specific learning objectives under the supervision
of a qualified clinical preceptor.
(13)
Clinical teaching assistant--A registered nurse licensed
in Texas, who is employed to assist and work under the supervision of a Master's
or Doctorally prepared faculty member and who meets the minimum requirements
in §215.10(g)(4) of this chapter.
(14)
Coordinator--A qualified faculty who has the delegated
responsibility for the day to day administration of an accredited professional
nursing program or one or more distance education initiatives.
(15)
Course--A specific set of organized learning experiences
that must be met within a stated time period. A course involves both organized
subject matter and related activities. In a clinical nursing course, the didactic
content shall be taught either prior to or concurrent with the related clinical
learning experiences.
(16)
Curriculum--Content designed to achieve specific educational
outcomes.
(17)
Dean/Director--A registered nurse who is accountable for
administering one or more of the following: basic nursing program or a post-licensure
baccalaureate or higher degree program for registered nurses and who meets
the requirements as stated in §215.6(f) of this chapter (relating to
Administration and Organization).
(18)
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, Vocational (VN), Diploma/Associate
Degree (Dip/ADN), Baccalaureate (BSN)
, September 2002.
(19)
Distance education initiative--Instruction provided by
an accredited nursing program utilizing a variety of instructional methods
to any location(s) other than the program's main campus and where students
are required to attend activities such as testing, group conferences, campus
laboratory. A distance education initiative may range from offering the entire
identical curriculum to offering a single course or multiple courses.
(A)
Complete program--Provides the entire program of study
at a site other than the program's main campus.
(B)
Partial program--Provides a course or courses from the
program of study at a site other than the program's main campus.
(20)
Examination year--A twelve month period defined by the
Board.
(21)
Faculty currency/clinical competence--Maintenance of up-to-date
knowledge and professional practice as demonstrated by certification and/or
through participation in: continuing education, professional conferences,
advanced academic courses, workshops, research projects, seminars, publications,
clinical practice, and/or extended orientation.
(22)
Faculty member--An individual employed to teach in the
nursing program who meets the requirements as stated in §215.7 of this
chapter (relating to Faculty Qualifications and Faculty Organization).
(23)
Faculty petition--A request submitted to the Board petitioning
to employ an individual who does not meet the requirements stated in §215.7
of this chapter.
(24)
Faculty role--The activities which require the time of
the faculty member and are related, directly or indirectly, to the performance
of his/her professional education duties and responsibilities.
(25)
Faculty waiver--A waiver granted by the Board to an individual
who has a baccalaureate degree in nursing and is currently licensed in Texas
to be employed as a faculty member for a limited period of time.
(26)
Governing institution--An accredited college, university,
or hospital responsible for the administration and operation of a Board accredited
nursing program.
(27)
Health care professional--An individual other than a RN
who holds at least a bachelor's degree in the health care field, including,
but not limited to: respiratory therapists, physical therapists, occupational
therapists, dieticians, pharmacists, physicians, social workers and psychologists.
(28)
Instructional Methods--Includes traditional methods of
delivering instruction such as lecture and group work, as well as innovative
methods such as on-line courses and interactive television.
(29)
Mission--The purpose and overall role of the educational
unit in nursing which are consistent with those of the governing institution.
(30)
Mobility--The ability to advance without educational barriers.
(31)
Observational experience--An assignment to a facility
or unit where students observe the functions of the facility and the role
of nursing within the facility, but where students do not participate in patient/client
care.
(32)
Pass rate--The percentage of first-time candidates within
one examination year who pass the National Council Licensure Examination for
Registered Nurses.
(33)
Philosophy--The underlying belief system of the educational
nursing unit.
(34)
Post-Licensure nursing program--An educational unit the
purpose of which is to provide mobility options for registered nurses to attain
undergraduate academic degrees in nursing. Post-licensure programs may be
components of educational units within basic nursing programs or independent
baccalaureate degree programs for registered nurses as defined in this section.
(35)
Pre-Licensure nursing program--See basic nursing program.
(36)
Professional Nursing Program--An educational entity that
offers the courses and learning experiences that constitute the requirements
for a basic nursing program (diploma program, associate degree program, baccalaureate
degree program, master's degree alternate entry program) or a post-licensure
program.
(37)
Professional nursing student--An individual enrolled in
a professional nursing program who has met admission criteria and is designated
as a nursing student according to governing institution's policies.
(38)
Program goals/outcomes--The expected competencies of program
graduates with regard to professional nursing practice.
(39)
Program of study--The courses and learning experiences
that constitute the requirements for completion of a basic nursing program
(associate degree program, baccalaureate degree program, master's degree program,
or diploma program) or a post-licensure nursing program.
(40)
Shall and must--Mandatory requirements.
(41)
Should--A recommendation.
(42)
Staff--Employees of the Board of Nurse Examiners.
(43)
Supervision--Immediate availability of a faculty member,
clinical preceptor, or clinical teaching assistant to coordinate, direct,
and observe at first hand the practice of students.
§215.3.Program Development, Expansion and Closure.
(a)
New programs.
(1)
Proposal to develop a professional pre-licensure or post-licensure
nursing program.
(A)
A governing institution accredited by a Board recognized
accrediting body is eligible to submit a proposal to develop a professional
nursing program. Notice of intent to establish a nursing program shall be
submitted in writing 12 - 18 months prior to the anticipated start of the
program.
(B)
The proposal shall be completed under the direction/consultation
of a registered nurse who holds at least a master's degree in nursing and
who has teaching and administrative experience in the type of program being
proposed.
(C)
The proposal shall include information outlined in Board
guidelines.
(D)
The proposal will be considered by the Board following
a public hearing at a regularly scheduled meeting of the Board. The Board
may approve the proposal, may defer action on the proposal, or may deny further
consideration of the proposal.
(2)
Application for initial accreditation.
(A)
Following approval to develop a professional nursing program,
a director, faculty, and support staff shall be employed to develop the application
for initial licensure as outlined in an Order of the Board.
(B)
Initial accreditation must be granted prior to admission
of students.
(C)
The director and faculty shall plan the program of learning.
(D)
The application shall include information outlined in Board
guidelines.
(E)
The Board shall review the application and supporting evidence
at a regularly scheduled meeting. If the program is based upon sound educational
principles and is in compliance with the Board's requirements as specified
in §§215.2 - 215.13 of this chapter (relating to Definitions; Program
Development, Expansion, and Closure; Accreditation; Mission and Goals (Philosophy
and Outcomes); Administration and Organization; Faculty Qualifications and
Faculty Organization; Students; Program of Study; Management of Clinical Learning
Experiences and Resources; Facilities, Resources, and Services; Records and
Reports; and Total Program Evaluation), then initial accreditation may be
granted and an initial accreditation fee assessed per §223.1 of this
title (relating to Fees).
(3)
Survey visits shall be conducted, as necessary, by staff
until full accreditation is granted.
(b)
Program Expansion
(1)
Only nursing programs that have full accreditation are
eligible to initiate or modify distance education initiatives.
(2)
Instruction provided for the distance education initiative
may include a variety of instructional methods and shall be congruent with
the program's curriculum plan and shall enable students to meet the goals,
objectives, and competencies of the educational program and requirements of
the Board as stated in §§215.2 - 215.13 of this chapter.
(3)
A program intending to establish a distance education initiative
shall:
(A)
Notify the board at least four months prior to implementation
of distance education initiatives by any accredited program, and
(B)
Submit required information according to board approved
guidelines.
(C)
Provide documentation of notification to the Regional Council
of the governing institution about plans for establishment of distance education
initiatives to the Board at least four months prior to implementation, as
appropriate.
(D)
Provide evidence of approval from the Texas Higher Education
Coordinating Board and other regulating/accrediting bodies to the Board prior
to implementation, as appropriate.
(4)
Distance education initiatives of basic nursing programs
which have been closed may be reactivated by submitting notification of reactivation
to the Board at least 4 months prior, using the board guidelines for initiating
a distance education initiative.
(c)
Transfer of Administrative Control by Governing Institutions.
(1)
A governing institution of a professional nursing education
program which has Full Accreditation status may request permission from the
Board to transfer administrative control.
(A)
A governing institution that proposes to transfer administrative
control of a nursing program to another governing institution accredited by
a board recognized accrediting body shall submit:
(i)
notice of intent to transfer administrative control in
writing to the Board 12 months prior to the anticipated date of transfer;
and
(ii)
a written plan for closure of the nursing program as required
by subsection (d) of this section.
(B)
The governing institution which will assume responsibility
for the program shall submit a Proposal to Assume Administrative Control to
the Board six months prior to a regularly scheduled Board meeting.
(i)
The proposal shall be completed under the direction/consultation
of a registered nurse who holds at least a master's degree in nursing and
who has teaching and administrative experience in the type of program being
proposed.
(ii)
The proposal shall include information outlined in board
approved guidelines.
(iii)
The proposal shall include documentation of Texas Higher
Education Coordinating Board approval, as applicable.
(iv)
The proposal will be considered by the Board at a regularly
scheduled meeting.
(v)
The Board may approve, may defer action, or may deny further
consideration of the proposal.
(2)
Accreditation status of transferred nursing program(s).
(A)
If the governing institution that is assuming administrative
control previously has been responsible for an accredited professional nursing
program and does not intend to change the program of study then the professional
nursing education program shall maintain its accreditation status.
(B)
If the governing institution that is assuming administrative
control previously has been responsible for an accredited professional nursing
program and intends to alter the program of study then that governing institution
shall submit a proposal to change the program of study in accordance with §215.9(i)
of this chapter (relating to Program of Study).
(C)
If the governing institution that is assuming administrative
control has not previously been responsible for an accredited professional
nursing program then that governing institution shall submit an application
for initial accreditation in accordance with subsection (a)(2) of this section.
(d)
Closing a Program or DEI.
(1)
When the decision to close a program which provides the
entire program of study has been made, the director must notify the Board
and submit a written plan for closure which includes the following:
(A)
reason for closing the program;
(B)
date of intended closure;
(C)
academic provisions for students;
(D)
provisions made for access to and safe storage of vital
school records, including transcripts of all graduates; and
(E)
methods to be used to maintain requirements and standards
until the program closes.
(2)
The program or distance education initiative shall continue
within standards until all classes, which are enrolled at the time of the
decision to close, have graduated. In the event this is not possible, a plan
must be developed whereby students may transfer to other accredited programs.
(3)
Programs that close a DEI which provides the full program
of study shall notify the board office in writing at least four months prior
to the intent to close, providing:
(A)
location and name of the program;
(B)
reason; and
(C)
the date of the intended closure.
§215.4.Accreditation.
(a)
The progressive designation of accreditation status is
not implied by the order of the following listing. Accreditation status is
based upon each program's performance and demonstrated compliance to the Board's
requirements. Change from one status to another is based on NCLEX-RN®
examination pass rates and annual reports or survey visits. Types of accreditation
include:
(1)
Initial accreditation. Initial accreditation is written
authorization to admit students and is granted if the program meets the requirements
of the Board.
(2)
Full accreditation--basic nursing program. Full accreditation
is granted to a basic nursing program after the program has documented compliance
with subsection (c)(2)(A) of this section. Only programs with full accreditation
status may propose distance education initiatives and petition for faculty
waivers.
(3)
Full Accreditation--post-licensure nursing programs. Full
accreditation is granted to a post-licensure nursing program after one class
has completed the program and the program meets the Board's legal and educational
requirements.
(4)
Warning.
(A)
Issuance of warning. When the Board determines that a program
is not meeting legal and educational requirements, the program is issued a
warning, is provided a list of the deficiencies, and is given a specified
time in which to correct the deficiencies.
(B)
Failure to correct deficiencies. If the program fails to
correct the deficiencies within the prescribed period the Board may restrict
admissions or other program activities until the deficiencies are corrected
or the Board may place the program on conditional accreditation or withdraw
accreditation.
(5)
Conditional accreditation. Conditional accreditation is
granted for a time specified by the Board in order to provide additional time
to correct deficiencies.
(A)
The program shall not admit students while on conditional
status.
(B)
The Board may establish specific criteria to be met in
order for the program's conditional accreditation status to be removed.
(C)
Depending upon the degree to which the Board's legal and
educational requirements are met, the Board may change the accreditation status
to full, warning, or withdraw accreditation.
(b)
Withdrawal of accreditation. A program which fails to meet
legal and educational requirements of the Board within the specified time
shall be removed from the list of state accredited nursing programs. Reasons
for withdrawal of accreditation include but are not limited to:
(1)
Continued lack of compliance with minimum requirements
as set out in this chapter, and
(2)
Failure to meet specific criteria set out by the Board.
(c)
Accreditation procedures. The continuing accreditation
status of each program shall be determined annually by the Board based upon:
(1)
Review of annual report. Each accredited professional nursing
program shall submit an annual report regarding its compliance with the Board's
legal and educational requirements. Accreditation status is determined on
the basis of the program's annual report, NCLEX-RN® examination pass rate,
and other pertinent data when a program is not visited by staff during the
examination year.
(2)
Pass rate of graduates on NCLEX-RN® examination.
(A)
In order for the nursing program to attain or maintain
full accreditation, 80% of first-time candidates who complete the program
of study must achieve a passing score on the NCLEX-RN® examination for
two consecutive examination years.
(B)
When first-time candidates who complete the nursing program
of study fail to achieve at least 80% during one examination year, the nursing
program shall submit a self-study report that evaluates factors which contributed
to the graduates' performance on the NCLEX-RN® examination and a description
of the corrective measures to be implemented. The report shall follow Board
guidelines.
(C)
A warning will be issued to the program based on the pass
rate when the pass rate of first-time candidates, as described in subparagraph
(A) of this paragraph, is less than 80% for two consecutive examination years.
(D)
A program may be placed on conditional accreditation status
if, within one examination year from the date of the warning, the performance
of graduates fails to be at least 80%, or the faculty fail to implement appropriate
corrective measures.
(E)
Accreditation may be withdrawn if the performance of graduates
fails to be at least 80% during the examination year following the date that
the program is placed on conditional accreditation.
(F)
A program placed on warning or conditional accreditation
status may request a review of the program accreditation status by the Board
at a regularly scheduled meeting if the program's pass rate for first-time
candidates during one examination year is at least 80%.
(d)
Survey visit. Each nursing program will be visited at least
every six years after full accreditation has been granted, unless accredited
by a Board recognized voluntary accrediting body.
(1)
The Board may authorize staff to conduct a survey visit
at any time based upon established criteria.
(2)
After a program is fully accredited by the Board, a report
from a Board recognized voluntary accrediting body regarding a program's accreditation
status may be accepted in lieu of a Board survey visit.
(3)
A written report of the survey visit, annual report, and
NCLEX-RN® examination pass rate will be reviewed by the Board at a regularly
scheduled meeting.
(e)
Notice of a program's accreditation status will be sent
to the director, chief administrative officer of the governing institution,
and others as determined by the Board.
§215.8.Students.
(a)
Students should have mechanisms for input into the development
of academic policies and procedures, curriculum planning, and evaluation of
teaching effectiveness.
(b)
The number of students admitted to the program shall be
determined by the number of qualified faculty, adequate educational facilities
and resources, and the availability of appropriate clinical learning experiences
for students.
(c)
Written policies regarding nursing student admission and
progression shall be developed and implemented in accordance with the requirements
that the governing institution must meet to maintain accreditation. Student
policies which differ from those of the governing institution shall be in
writing and shall be made available to faculty and students.
(d)
Policies shall facilitate mobility/articulation, be consistent
with acceptable educational standards, and be available to students and faculty.
(e)
Students shall have the opportunity to evaluate faculty,
courses, and learning resources and these evaluations shall be documented.
(f)
Individuals enrolled in accredited professional nursing
programs preparing students for initial licensure shall be provided verbal
and written information regarding conditions that may disqualify graduates
from licensure and of their rights to petition the Board for a Declaratory
Order of Eligibility. Required eligibility information includes:
(1)
Texas Occupations Code §301.253 and §§301.452
- 301.469.
(2)
Sections 213.27 - 213.30 of this title (relating to Good
Professional Character, Licensure of Persons with Criminal Convictions, Criteria
and Procedure Regarding Intemperate Use and Lack of Fitness and Declaratory
Order of Eligibility for Licensure).
(g)
The nursing program shall maintain written receipt of eligibility
notification for up to six months after the individual enrolled completes
the nursing program or permanently withdraws from the nursing program.
(h)
The Director of the Nursing Program shall submit an affidavit
each year with the Annual Report which verifies that enrolled students received
the eligibility information.
§215.9.Program of Study.
(a)
The program of study shall be:
(1)
at least the equivalent of two academic years and shall
not exceed four calendar years;
(2)
planned, implemented, and evaluated by the faculty;
(3)
based on the mission and goals (philosophy and outcomes);
(4)
organized logically, sequenced appropriately;
(5)
based on sound educational principles;
(6)
designed to prepare graduates to practice according to
the Standards of Nursing Professional Practice as set forth in the Board's
Rules and Regulations; and
(7)
designed and implemented to prepare students to demonstrate
the Differentiated Entry Level Competencies of Graduates of Texas Nursing
Programs, Vocational (VN), Diploma/Associate Degree (Dip/ADN), Baccalaureate
(BSN).
(b)
There shall be a reasonable balance between non-nursing
courses and nursing courses which are offered in a supportive sequence with
rationale and are clearly appropriate for collegiate study.
(c)
There shall be a rationale for the ratio of contact hours
assigned to classroom and clinical learning experiences. The recommended ratio
is three contact hours of clinical learning experiences for each contact hour
of classroom instruction.
(d)
The program of study should facilitate articulation among
programs.
(e)
The program of study shall include, but not be limited
to the following areas:
(1)
non-nursing courses, clearly appropriate for collegiate
study, offered in a supportive sequence.
(2)
nursing courses which include didactic and clinical learning
experiences in the four content areas, medical-surgical, maternal child health,
pediatrics and mental health nursing that teach students to use a systematic
approach to clinical decision making and prepare students to safely practice
professional nursing through the promotion, prevention, rehabilitation, maintenance,
and restoration of the health of individuals of all ages.
(A)
Course content shall be appropriate to the role expectations
of the graduate.
(B)
Professional values including ethics, safety, diversity,
and confidentiality shall be addressed.
(C)
The Nursing Practice Act, Standards of Professional Nursing
Practice, Unprofessional Conduct Rules, Delegation Rules, and other laws and
regulations which pertain to various practice settings shall be addressed.
(3)
Nursing courses shall prepare students to recognize and
analyze health care needs, select and apply relevant knowledge and appropriate
methods for meeting the health care needs of individuals and families, and
evaluate the effectiveness of the nursing care.
(4)
Baccalaureate and entry-level master's degree programs
in nursing shall include learning activities in basic research and management/leadership,
and didactic and clinical learning experiences in community health nursing.
(f)
The learning experiences shall provide for progressive
development of values, knowledge, judgment, and skills.
(1)
Didactic learning experiences shall be provided either
prior to or concurrent with the related clinical learning experiences.
(2)
Clinical learning experiences shall be sufficient in quantity
and quality to provide opportunities for students to achieve the stated outcomes.
(3)
Students shall have sufficient opportunities in simulated
or clinical settings to develop manual technical skills, using contemporary
technologies, essential for safe, effective nursing practice.
(4)
Learning opportunities shall assist students to develop
communication and interpersonal relationship skills.
(g)
Faculty shall develop and implement evaluation methods
and tools to measure progression of students' cognitive, affective and psychomotor
achievement in course/clinical objectives according to Board guidelines.
(h)
Staff approval is required prior to implementation of major
curriculum changes by a professional nursing program. Proposed changes shall
include information outlined in Board guidelines and shall be reviewed using
Board standards.
(1)
Changes that require approval include:
(A)
changes in program mission and goals (philosophy and outcomes)
which result in a reorganization or re-conceptualization of the entire curriculum,
including but not limited to changing from a block to an integrated curriculum.
(B)
the addition of transition course(s), tracks/alternative
programs of study that provide educational mobility.
(C)
all programs implementing a major curriculum change shall
provide an evaluation of the outcomes of these changes and submit with the
Annual Report through the first graduating class.
(2)
All other revisions such as editorial updates of mission
and goals or redistribution of course content or course hours shall be reported
to the Board in the Annual Report.
(3)
Documentation of Governing Institution approval or Texas
Higher Education Coordinating Board approval must be provided to the Board
prior to implementation of changes, as appropriate.
(i)
Nursing programs that have full accreditation and are undergoing
major curriculum changes shall submit an abbreviated proposal to the office
for approval at least 4 months prior to implementation. The abbreviated proposal
shall contain the following:
(1)
the new philosophy, major concepts;
(2)
program and course outcomes; and
(3)
clinical evaluation tools for each clinical course.
(j)
Nursing programs not having full accreditation and that
are undergoing a major curriculum change shall submit a full curriculum change
proposal and meet the requirements as outlined in subsection (h) of this section.
§215.10.Management of Clinical Learning Experiences and Resources.
(a)
In all cases faculty shall be responsible and accountable
for managing clinical learning experiences and observational experiences of
students.
(b)
Faculty shall develop criteria for the selection of affiliate
agencies or clinical practice settings which address safety and the need for
students to achieve the program outcomes (goals) through the practice of nursing
care or observational experiences.
(c)
Faculty shall select and evaluate affiliate agencies or
clinical practice settings which provide students with opportunities to achieve
the goals of the program.
(1)
Written agreements between the program and the affiliate
agencies shall specify the responsibilities of the program to the agency and
the responsibilities of the agency to the program.
(2)
Agreements shall be reviewed periodically and include provisions
for adequate notice of termination.
(d)
The faculty member shall be responsible for the supervision
of students in clinical learning experiences.
(1)
When a faculty member is the only person officially responsible
for a clinical group, then the group may total no more than ten students.
Patient safety shall be a priority and may mandate ratios as low as one faculty
member to six students. The faculty member must supervise that group in only
one facility at a time, unless some portion or all of the clinical group are
assigned to observational experiences in additional settings.
(2)
Direct faculty supervision is not required for an observational
experience.
(A)
Observational experiences may be used to supplement, but
not replace patient care experiences, and must serve the purpose of student
attainment of clinical objectives.
(B)
Observational experiences should comprise no more than
20% of the clinical contact hours for a course and no more than 10% of the
clinical contact hours for the program-of-study.
(e)
Faculty may use clinical preceptors or clinical teaching
assistants to enhance clinical learning experiences and to assist faculty
in the clinical supervision of students.
(1)
Faculty shall develop written criteria for the selection
of clinical preceptors and clinical teaching assistants.
(2)
When clinical preceptors or clinical teaching assistants
are used, written agreements between the professional nursing program, clinical
preceptor or clinical teaching assistant, and the affiliating agency, when
applicable, shall delineate the functions and responsibilities of the parties
involved.
(3)
Faculty shall be readily available to students and clinical
preceptors or clinical teaching assistants during clinical learning experiences.
(4)
The designated faculty member shall meet periodically with
the clinical preceptors or clinical teaching assistants and student(s) for
the purpose of monitoring and evaluating learning experiences.
(5)
Written clinical objectives shall be shared with the clinical
preceptors or clinical teaching assistants prior to or concurrent with the
experience.
(f)
Clinical preceptors may be used to enhance clinical learning
experiences after a student has received clinical and didactic instruction
in all basic areas of nursing or within a course after a student has received
clinical and didactic instruction in the basic areas of nursing for that course
or specific learning experience.
(1)
In courses which use clinical preceptors for a portion
of clinical learning experiences, faculty shall have no more than 12 students
in a clinical group.
(2)
In a course which uses clinical preceptors as the sole
method of student instruction and supervision in clinical settings, faculty
shall coordinate the preceptorships for no more than 24 students.
(3)
The preceptor may supervise student clinical learning experiences
without the physical presence of the faculty member in the affiliate agency
or clinical practice setting.
(4)
The preceptor shall be responsible for the clinical learning
experiences of no more than two students per clinical day.
(5)
Clinical preceptors shall have the following qualifications:
(A)
competence in designated area of practice;
(B)
philosophy of health care congruent with that of the nursing
program; and
(C)
current licensure or privilege as a registered nurse in
the State of Texas; or
(D)
if not a registered nurse, a current license in Texas as
a health care professional with a minimum of a bachelor's degree in that field.
(g)
Clinical teaching assistants may assist qualified, experienced
faculty with clinical learning experiences.
(1)
In clinical learning experiences where a faculty member
is supported by a clinical teaching assistant, the ratio of faculty to students
shall not exceed 2:15 (faculty plus clinical teaching assistant: student).
(2)
Clinical teaching assistants shall supervise student clinical
learning experiences only when the qualified and experienced faculty member
is physically present in the affiliate agency or alternative practice setting.
(3)
When acting as a clinical teaching assistant, the RN shall
not be responsible for other staff duties, such as supervising other personnel
and/or patient care.
(4)
Clinical teaching assistants shall meet the following criteria:
(A)
hold a current license or privilege to practice as a registered
nurse in the State of Texas;
(B)
hold a bachelor's degree in nursing from an accredited
baccalaureate program in nursing; and
(C)
have the clinical expertise to function effectively and
safely in the designated area of teaching.
This agency hereby certifies that the adoption
has been reviewed by legal counsel and found to be a valid exercise of the
agency's legal authority.
Filed with the Office of
the Secretary of State on July 28, 2003.
TRD-200304576
Katherine Thomas
Executive Director
Board of Nurse Examiners
Effective date: August 17, 2003
Proposal publication date: May 16, 2003
For further information, please call: (512) 305-6823
Chapter 851.
TEXAS BOARD OF PROFESSIONAL GEOSCIENTISTS LICENSING RULES
Subchapter B. CODE OF PROFESSIONAL CONDUCT
Part 39.
TEXAS BOARD OF PROFESSIONAL GEOSCIENTISTS