Welcome to the Texas Board of Nursing

Texas Board of Nursing Rules and Regulations
relating to
Nurse Education, Licensure and Practice


This manual, based on statutory authority as provided for in Chapters 301, 303, and 304 of the Texas Occupations Code Annotated (Nursing Practice Act), has been prepared by the Texas Board of Nursing. It sets forth the rules and regulations established by the Board to regulate nursing education and the practice of nursing in the state. Members of the Board of Nursing have sought input from interested groups and individuals in developing and revising these rules and regulations.


During the 19th century, the public became aware of the value of nursing as an indispensable ally of the medical arts and sciences and as an occupation predicated upon formal education. The first nursing laws were enacted in the United States in 1903.

The original Nursing Practice Act of Texas was passed March 28, 1909. The passage of this Act marked a milestone in the health care of the citizens of the State of Texas as nursing was formally recognized as a vital service to society. The purpose of the Act is to provide that the privilege and responsibility of practicing nursing be entrusted only to those persons duly licensed and practicing under the provisions of the Act. The Act provides for the creation of a Board of Nursing (Board) empowered with the responsibility and legal authority for ensuring competent practitioners of nursing. The Board fulfills this responsibility by licensing qualified practitioners, controlling the practice of nursing in the interest of society by licensure, by investigation of violations of the Act, by initiating appropriate legal action when necessary, and by establishing minimum standards for educational programs in nursing. Without legal regulation of nursing practices, the public has no assurance that the nurses who provide nursing care as a part of the total health care plan are qualified to do so. The Board meets regularly to execute its responsibilities for administering the law governing nurse practice. Professional and nonprofessional personnel are employed to carry out the provisions of the law, and the policies and regulations established by the Board. Legal counsel is retained by the Board as provided by the law, to represent it in matters pertaining to the implementation of the law.

It is the responsibility of the Board to establish standards for nursing education in the State of Texas. The Board shall approve such nursing education programs that meet its requirements, and shall deny or withdraw approval from schools of nursing and educational programs which fail to meet the prescribed course of study or other standards. The intent of the approval process is to improve the educational programs and stimulate continuous self-study, evaluation, innovation, and appropriate changes within the programs. The Board provides guidance to nursing programs so that a high quality education for the preparation of practitioners is ensured. The preparation of a practitioner competent to practice, however, is the responsibility of the school. The services of the Board are available to the faculty of educational programs, to staff of health agencies utilizing nursing services, and to practitioners of nursing as the need may arise.

The Board conducts regularly scheduled meetings which are open to the public. The notice of the meeting including agenda items, and the time and place of the meeting is posted with the Secretary of State’s office approximately two weeks in advance. Special meetings of the Board shall be called by the President acting upon the written request of any two members.


Mission Statement

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


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


Table of Contents

General Provisions — §§ 211.1 — 211.9

Practice and Procedure — §§ 213.1 — 213.35


Vocational Nursing Education — §§ 214 .1 — 214.13

Professional Nursing Education — §§ 215 .1 — 215.13

Continuing Competency — §§ 216.1 — 216.11


Licensure, Peer Assistance and Practice — §§ 217.1 — 217.24

Advanced Practice Nurse Education — §§ 219.1 — 219.13


Nurse Licensure Compact — §§ 220.1 — 220.4

Advanced Practice Nurses — §§ 221.1 — 221.17

Advanced Practice Registered Nurses with Prescriptive Authority — §§ 222.1 — 222.10


Fees — §§ 223.1 — 223.2

Delegation of Nursing Tasks by Registered Professional Nurses to Unlicensed Personnel for Clients with Acute Conditions or in Acute Care Environments — §§ 224.1 — 224.11

RN Delegation to Unlicensed Personnel and Tasks Not Requiring Delegation in Independent Living Environments for Clients with Stable and Predictable Conditions — §§ 225.1 — 225.15

Patient Safety Pilot Programs on Nurse Reporting Systems — §§ 226.1 — 226.7


Pilot Programs for Innovative Applications to Vocational and Professional Nursing Education — §§ 227.1 — 227.4


Pain Management— §§ 228.1— 228.2