Texas Nurse Practice Act: Facility Guide
The Texas Nurse Practice Act (NPA) outlines the rules and regulations for nurses practicing in the state. While these rules and regulations are required for nursing professionals across the country, the profession was poorly regulated in the U.S. prior to the early 1900s. There were no laws in place that set standards for care and without clinician registering or licensing, it was challenging to provide oversight on care quality.
The Texas Nursing Practice Act, as it’s formally named, holds nursing professionals accountable for the care they provide. It also specifies licensure requirements, degree expectations, and law violation penalties for nursing professionals practicing in the state of Texas.
In this article, we summarize the rules set by the Texas NPA, outline key elements that affect nursing practice, and provide tips for Texas healthcare leaders looking to better understand their Nursing Practice Act and promote safer nursing care within their facilities.
What Are the Components of the Nurse Practice Act?
Texas RNs, LVNs, and APRNs are required to follow certain guidelines to ensure high-quality care under the state’s nurse practice act. In Texas, this legislation influences nursing practice by:
- Establishing Texas Board of Nursing rules and regulations.
- Describing requirements for Texas nursing education programs.
- Setting minimum care standards that must be met.
- Regulating the maintenance and renewal of a Texas nursing license.
- Clarifying and setting penalties for violations.
The Texas Nurse Practice Act: Laws at a Glance
Most state Nurse Practice Acts have similar processes for regulating their nursing board and establishing legal requirements for obtaining a license. Additionally, each state NPA outlines specific laws for delegating tasks and establishing penalties for rule violation.
Understanding the intricacies of your state’s nursing practice law is essential to providing exceptional patient care. In the chart below, we list some of the key components unique to the Texas Nurse Practice Act.
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| Legal Authorities | Texas Occupational Code, Chapter 301: Nurses
Texas Administrative Code, Title 22, Part 11, Chapters 211-288: Texas Board of Nursing Texas Occupational Code, Chapter 304: Nurse Licensure Compact |
| Texas State Nursing Licensure Requirements | RN licensure applicants must qualify by either passing the NCLEX examination or getting a license endorsed from another state.
Steps for NCLEX Exam Qualification:
Steps for Endorsement Qualification:
The Texas Board of Nursing website also provides approximate timeframes for application processing and outlines the steps to renew a nursing license. |
| Texas Nurse Practice Act Delegation of Duties | Nursing professionals are allowed to delegate:
A task that the registered nurse determines the unlicensed employee is competent to perform, including:
Nursing professionals are prohibited from delegating: Nursing activities not within the delegating or supervising nurse’s scope of practice or activities that include the use of the nursing process, including:
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| Penalties | Under Section 301.554, the following can constitute a Class A Misdemeanor in Texas:
Note that repeated offenses of the above can constitute a Third Degree Felony and each day of a violation constitutes a separate offense. A conviction of any of the above can result in forfeiture of a nursing license. Under Section 301.452, a nursing professional can face disciplinary action for, among other things:
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| Nurse Licensure Compact (NLC) State? | Texas is involved in the NLC compact, meaning that its state Nurse Practice Act encompasses rules and guidelines established by the NLC. |
Promoting Safe Nursing Practice: 3 Strategies for Facilities
By adhering to the laws specified in the Nursing Practice Act, Texas clinicians and facility leaders can enhance regulatory compliance and ensure their team performs to the highest standards.
However, familiarizing yourself with the Texas NPA is only the first step to improving care. It’s equally important to incorporate the laws into facility policies and procedures to support your team and optimize care quality. Here are three strategies for getting started.
1. Review Key Components of the NPA During Staff Training
Reviewing the components of the NPA during employee onboarding and annual competency training sessions can improve staff engagement and compliance. Provide all nursing professionals with an electronic copy of the Texas Nurse Practice Act and post information on any legal updates in your facility’s common areas.
2. Educate Patients on Care Provider Roles
Staff members often feel obligated to perform duties outside of their scope of practice when asked to do so by patients and family members. Conversely, patients may feel that their health is at risk if they witness a care provider practicing outside of their legal scope. The easiest way to prevent this from happening is by educating patients on the responsibilities of each of their care providers.
Empower staff to say “no” or ask for assistance from another clinician when asked to do something outside of specified role requirements. Let patients know that it’s okay to speak up to healthcare management if they witness a staff member performing an inappropriate or unusual task. Promoting these practices can help you build a culture of safety that protects patients and keeps employees from unintentionally breaking state practice laws.
3. Encourage Shared Governance in Nursing
This leadership model involves nurses in the process of developing facility-wide nursing policies. It also promotes collaboration and teamwork among your clinical providers. Empowering clinical nurses with decision-making power promotes nurse engagement and encourages them to manage their own professional practice.
Discover More Ways to Improve Care and Stay Compliant
Now that you’ve taken the time to understand the Texas Nurse Practice Act, you may be wondering what additional steps you can take to improve regulatory compliance at your facility. Follow our newsletter to find out more about healthcare policy changes and regulatory updates — sent straight to your inbox.
Legal Disclaimer: This article contains general legal information, but it is not intended to constitute professional legal advice for any particular situation and should not be relied on as professional legal advice. Any references to the law may not be current, as laws regularly change through updates in legislation, regulation, and case law at the federal and state level. Nothing in this article should be interpreted as creating an attorney-client relationship. If you have legal questions, you should seek the advice of an attorney licensed to practice in your jurisdiction.