SECTION 221.12. Scope of Practice

(a) Advanced practice registered nurses (APRNs) practice in a variety of settings and provide a broad range of health care services to a variety of patient populations within their Board authorized role and population focus area.

(b) APRNs may only perform those functions that are within their Board authorized professional and individual scopes of practice for their role and population focus area and that are consistent with the Nursing Practice Act, Board rules, and other applicable laws and regulations affecting their practice in Texas.

(c) In determining whether a particular action falls within an APRN's authorized professional and/or individual scope of practice, the following factors will be considered:

(1) Whether the APRN received training regarding the performance of the particular action in his/her advanced educational program;

(2) Whether the action falls within generally acceptable standards of care appropriate for the APRN's role and population focus area, as determined by a professional specialty organization;

(3) Whether the APRN has demonstrable clinical competence and/or clinical experience in performing the action in the role of an APRN, obtained through supervision and/or training by a qualified practitioner;

(4) Whether the APRN has been credentialed by a health care facility's credentialing body and/or holds a privilege to perform the action at a health care facility;

(5) Whether the APRN has completed additional training for the specific action being performed. Additional training means education obtained by the APRN post-APRN licensure in his/her role and population focus area that is adequate for the action being performed by the APRN.

(A) To determine whether the additional training obtained by an APRN is adequate for the action being performed by the APRN, the following factors will be considered:

(i) the type of instruction provided, by way of example, and not limitation, online instruction; in-person instruction; didactic instruction; or clinical instruction;

(ii) the learning objectives, content, materials, and methods for evaluating participation contained in the training curriculum;

(iii) the length and/or quantity of the training;

(iv) the qualifications of the person/entity providing the training;

(v) whether the training has been certified or recognized by a professional specialty organization for the APRN's role and population focus area;

(vi) whether the training is consistent with evidence-based practice;

(vii) whether the training is sponsored by an educational institution, such as a formal fellowship or precepted experience; and

(viii) whether the training is provided by an entity in conjunction with the use of the entity's product, drug, or medical apparatus/equipment.

(B) All training must include a method of objective, verifiable participant competency following completion of the training.

(d) It is the responsibility of the APRN to maintain records of all completed training and competencies.

(e) An APRN is not prohibited from providing nursing care within the scope of practice of a registered nurse.

(f) Nothing in this section shall be construed to authorize an APRN to practice in a role or population focus area for which the APRN has not been licensed.

(g) An action that is determined to have been committed outside an APRN's authorized scope of practice may subject the APRN to discipline.

Source Note: The provisions of this §221.12 adopted to be effective February 25, 2001, 26 TexReg 1509; amended to be effective February 14, 2023, 48 TexReg 671