22 Tex. Admin. Code § 216.3 - Continuing Competency Requirements (2023)

(a) A nurse must meet either the requirementsof this subsection or subsection (b) of this section. A nurse may choose tocomplete 20 contact hours of continuing nursing education (CNE) in the nurse'sarea of practice within licensing period, as defined in this chapter. Thesecontact hours shall be obtained by participation in programs approved by acredentialing agency or provider recognized by the Board. A list of theseagencies/providers may be obtained from the Board's office orwebsite.

(b) A nurse must meeteither the requirements of this subsection or subsection (a) of this section. Anurse may choose to demonstrate the achievement, maintenance, or renewal of aBoard approved national nursing certification in the nurse's area of practicewithin the licensing period, as defined in this chapter. A list of approvednational nursing certifications may be obtained from the Board's office orwebsite.

(c) Requirements for theAPRN. A nurse licensed by the Board as an APRN is required to complete 20contact hours of continuing education or achieve, maintain, or renew thenational nursing certification recognized by the Board as meeting thecertification requirement for the APRN's role and population focus area oflicensure within the licensing period, as defined in this chapter.

(1) The required 20 contact hours are not inaddition to the requirements of subsection (a) or (b) of thissection.

(2) The 20 contact hours ofcontinuing education must be appropriate to the advanced practice role andpopulation focus area recognized by the Board.

(3) The APRN who holds prescriptive authoritymust complete, in addition to the requirements of this subsection, at leastfive additional contact hours of continuing education in pharmacotherapeuticswithin the licensing period.

(4) TheAPRN who has entered into a prescriptive authority agreement authorizing theprescribing of opioids must complete not less than two (2) hours of continuingeducation annually regarding safe and effective pain management related to theprescription of opioids and other controlled substances, including educationregarding reason-able standards of care; the identification of drug-seekingbehavior in patients; and effectively communicating with patients regarding theprescription of an opioid or other controlled substance. This requirementapplies to renewal of licensure on or after January 1, 2021.

(5) The APRN whose practice includes theprescription of opioids must attend at least one (1) hour of continuingeducation annually covering best practices, alternative treatment options, andmulti-modal approaches to pain management that may include physical therapy,psychotherapy, and other treatments. The content of the continuing educationdescribed by this paragraph must meet the requirements set forth by the TexasPharmacy Board. This requirement applies to renewal of licensure on or afterSeptember 1, 2019, and expires on August 31, 2023.

(6) The APRN who is licensed prior toSeptember 1, 2020, and authorized to receive information from the prescriptionmonitoring program (PMP) authorized by Chapter 481, Health and Safety Code,must complete two (2) hours of continuing education related to approvedprocedures of prescribing and monitoring controlled substances no later thanSeptember 1, 2021. The APRN licensed after September 1, 2020, and authorized toreceive information from the PMP, must complete the continuing educationrequired by this paragraph no later than one year after the APRN's initiallicensure date. This is a one-time education requirement.

(7) Category I Continuing Medical Education(CME) contact hours will meet requirements as described in this chapter, unlessotherwise prohibited.

(d)Forensic Evidence Collection.

(1) Pursuant tothe Health and Safety Code §323.004and §323.0045,a nurse licensed in Texas or holding a privilege to practice in Texas,including an APRN, who performs a forensic examination on a sexual assaultsurvivor must have basic forensic evidence collection training or theequivalent education prior to performing the examination. This requirement maybe met through the completion of CNE that meets the requirements of thissubsection. This is a one-time requirement. An APRN may use continuing medicaleducation in forensic evidence collection that is approved by the Texas MedicalBoard to satisfy this requirement.

(2) A nurse licensed in Texas or holding aprivilege to practice in Texas, including an APRN, who is employed in anemergency room (ER) setting must complete a minimum of two contact hours of CNErelating to forensic evidence collection that meets the requirements of thissubsection within two years of the initial date of the nurse's employment in anER setting. This is a one-time requirement.

(A) This requirement applies to nurses whowork in an ER setting that is:

(i) thenurse's home unit;

(ii) an ER unitto which the nurse "floats" or schedules shifts; or

(iii) a nurse employed under contractual,temporary, per diem, agency, traveling, or other employment relationship whoseduties include working in an ER.

(i)the nurse's home unit;

(ii) an ERunit to which the nurse "floats" or schedules shifts; or

(iii) a nurse employed under contractual,temporary, per diem, agency, traveling, or other employment relationship whoseduties include working in an ER.

(B) A nurse shall be considered to have metthe requirements of paragraphs (1) and (2) of this subsection if the nurse:

(i) completed CNE during the time period ofFebruary 19, 2006 through September 1, 2013; and

(ii) the CNE met the requirements of theBoard's rules related to forensic evidence collection that were in effect fromFebruary 19, 2006 through September 1, 2013.

(C) Completion of at least two contact hoursof CNE that meets the requirements of this subsection may simultaneouslysatisfy the requirements of paragraphs (1) and (2) of thissubsection.

(3) A nursewho would otherwise be exempt from CNE requirements for issuance of the initialTexas license and for the immediate licensing period following initial Texaslicensure under §216.8(b) or(c) of this chapter (relating to RelicensureProcess) shall comply with the requirements of this section. In compliance with§216.7(b)of this chapter (relating to Responsibilities of Individual Licensee), eachlicensee is responsible for maintaining records of CNE completion. Record ofcourse completion in forensic evidence collection should be retained by thenurse indefinitely, even if a nurse changes employment.

(4) Continuing education completed under thissubsection shall include information relevant to forensic evidence collectionand age or population-specific nursing interventions that may be required byother laws and/or are necessary in order to assure evidence collection thatmeets requirements under the Government Code §420.031regarding use of an Attorney General-approved evidence collection kit andprotocol. Content may also include, but is not limited to, documentation,history-taking skills, use of sexual assault kit, survivor symptoms, andemotional and psychological support interventions for victims.

(5) The hours of continuing educationcompleted under this subsection shall count towards completion of the 20contact hours of CNE required in subsection (a) of this section. Certificationrelated to forensic evidence collection that is approved by the Board may beused to fulfill the requirements of this subsection.

(e) A nurse who holds or is seeking to hold avalid Volunteer Retired (VR) Nurse Authorization in compliance with theOccupations Code §112.051and § 301.261(e) and §217.9(e)of this title (relating to Inactive and Retired Status):

(1) Must, if licensed by the Board as a LVNand/or RN, have completed at least 10 contact hours of CNE in his or her areaof practice within the two years immediately preceding application for, orrenewal of, VR status.

(2) Must, iflicensed by the Board as an APRN, have completed at least 20 contact hours ofcontinuing education in his or her area of practice within the two yearsimmediately preceding application for, or renewal of, VR status. The 20 hoursof continuing education must meet the same criteria as APRN continuingeducation defined under subsection (c) of this section. A nurse authorized as aVR-RN/APRN may not hold prescriptive authority. This does not preclude aregistered nurse from placing his or her APRN license on inactive status andapplying for authorization only as a VR-RN.

(3) Is exempt from fulfilling targetedcontinuing education requirements.

(f) Tick-Borne Diseases. An APRN whosepractice includes the treatment of tick-borne diseases is encouraged toparticipate in continuing education relating to the treatment of tick-bornediseases. The continuing education course(s) should contain informationrelevant to treatment of the disease within the APRN's role and populationfocus area of licensure and may represent a spectrum of relevant medicalclinical treatment relating to tick-borne disease. Completion of CME in thetreatment of tick-borne disease that meets the requirements of this subsectionshall count towards completion of the 20 contact hours of continuing educationrequired for APRNs in subsection (c) of this section.

(g) Nursing Jurisprudence and Nursing Ethics.Each nurse, including an APRN, is required to complete at least two contacthours of CNE relating to nursing jurisprudence and nursing ethics before theend of every third two-year licensing period applicable to licensing periodsthat began on or after January 1, 2014. The CNE course(s) shall containinformation related to the Texas Nursing Practice Act, the Board's rules,including §217.11of this title (relating to Standards of Nursing Practice), the Board's positionstatements, principles of nursing ethics, and professional boundaries. Thehours of CNE completed under this subsection shall count towards completion ofthe 20 contact hours of CNE required in subsection (a) of this section.Certification and/or CME may not be used to fulfill the CNE requirements ofthis subsection.

(h) Older Adult orGeriatric Care. A nurse, including an APRN, whose practice includes older adultor geriatric populations is required to complete at least two contact hours ofCNE relating to older adult or geriatric populations or maintain certificationin an area of practice relating to older adult or geriatric populations beforethe end of every licensing period, applicable to licensing periods that beganon or after January 1, 2014. The CNE course(s) may contain information relatedto elder abuse, age-related memory changes and disease processes, includingchronic conditions, end of life issues, health maintenance, and healthpromotion. The hours of CNE completed under this subsection shall count towardscompletion of the 20 contact hours of CNE required in subsection (a) of thissection. Certification related to older adult or geriatric populations that isapproved by the Board may be used to fulfill the CNE requirements of thissubsection.

(i) Human TraffickingPrevention. A nurse, including an APRN, who provides direct patient care mustcomplete a human trafficking prevention course approved by the Health and HumanServices Commission. This requirement applies to the renewal of a license on orafter September 1, 2020.


22 Tex. Admin. Code §216.3

The provisions of this §216.3 adopted to be effective August 16, 2009, 34 TexReg 5524; amended to be effective October 4, 2010, 35 TexReg 8917; amended to be effective July 16, 2012, 37 TexReg 5274; amended to be effective November 20, 2013, 38 TexReg 8208; amended to be effective February 23, 2014, 39 TexReg 982; Amended by Texas Register, Volume 43, Number 48, November 30, 2018, TexReg 7766, eff. 12/5/2018; Amended by Texas Register, Volume 44, Number 46, November 15, 2019, TexReg 7051, eff. 11/19/2019


What is the rule 216 related to continuing competency? ›

General Continuing Competency Information. Board Rule 216 is the Board's continuing competency rule and contains complete information on all of the requirements. All nurses who wish to maintain an active Texas license are required to demonstrate continuing competency for relicensure.

What do you need to renew your nursing license in Texas? ›

  1. Every two years. 20 hours of continuing education in area of practice. ...
  2. One-time requirement. 2 hours related to forensic evidence collection for those who work in an emergency room setting.
  3. Every six years. 2 hours related to nursing jurisprudence and nursing ethics.

How do I keep my nursing license active when not working in Texas? ›

In Texas if your license is inactive and you do not work in nursing for 4 years or more you are required to take a Refresher Course in order to reactivate it. (There is just a fee if less than four years). There is not an active work/employment requirement in Texas.

How often do Texas nurses have to take the jurisprudence exam? ›

Many states specify continuing education requirements that the nurse must fulfill for license renewal. For example, Texas (TX) requires nurses to complete their license renewal every 2 years.

What does continuing competence mean? ›

Continuing Competency is the demonstration of specified levels of knowledge, skills, or ability beyond CHES® and MCHES® certification and throughout an individual's professional career.

What is the difference between competence and continuing competence in a profession? ›

Competency: An individual's actual performance; that is, observed performance of applied knowledge, skill, or action measured against set criteria (e.g., competency-based measure). Continuing Competence: An individual's ongoing process of building their capacity to perform a task, function, or role.

What happens if you forget to renew your nursing license in Texas? ›

4. What happens if I don't renew my license before its current expiration date? According to the Texas Board of Nursing, any nurse who does not renew their license before its expiration date will be put on a DELINQUENT status. Nurses can NOT work in the state of Texas with a delinquent nursing license.

Can I be a CNA with a felony in Texas? ›

To start a CNA class, candidates can't have any felonies in the past 5 years. Misdemeanors involving theft or assault are also disqualifying. Pass the exam - In Texas, CNA trainees can work for four months before needing to pass the state exam.

How soon can you renew Texas nursing license? ›

Sixty days prior to your license expiring, the Texas Board of Nursing (BON) mails a renewal postcard to the last known address in our system. This postcard provides notification of the... renewal timeframe.

How long can I stop working as a nurse? ›

This is typically two years from the issued date. The time from the issued date to the expired date is considered your active period. This means that you are legally able to practice nursing during this time.

What do I have to do to keep my nursing license active? ›

CE requirements to practice
  1. To renew your nursing license, The Board of Registration in Nursing requires all licensed nurses in Massachusetts to complete 15 contact hours (CH). ...
  2. If you are an RN, you need to renew your license on your birthday in the even numbered years.

How can you lose your nursing license in Texas? ›

The board of nursing can revoke a nursing license for a variety of reasons, including:
  1. criminal convictions.
  2. lack of knowledge or skill in discharging professional obligations.
  3. unsafe practice.
  4. patient harm.
  5. substance abuse issues (including DUI and DWI)

Do you have to take the Texas nursing jurisprudence exam? ›

The NJE is one of the requirements that is required by Texas Board of Nursing to all applicants who are applying for initial licensure. The applicant must need to pass the NJE before the license will be issued by the board.

How many times can you fail NCLEX in Texas? ›

If they fail, they'll need to wait 45 days before retesting. After failing three times, though, they'll need to complete a board-approved remediation program before the next retake. test-takers have six attempts to pass in total.

How hard is the Texas Medical Jurisprudence exam? ›

As a doctor, you've taken USMLE Steps 1, 2CS/CK, and 3. The JP exam is not like those tests, in many ways, but particularly because this one is easy. Somewhere between three and five hours of high-yield review should be sufficient. However, don't take this relative ease further and attempt the test cold.

What are the three requirements of competence? ›

Competence involves knowledge, motivation, and skills.

What are the four areas of competence? ›

In the competence model, we focus on the following four dimensions: attitudes, knowledge, skills, and behaviours.

How often should competencies be updated? ›

The study looked at high performing companies on several criteria - high levels of leader retention, employee engagement, talent bench strength, accelerated change, and improved business results and found that 62% - 70% of high-performing organizations revamp their competencies every 2 - 3 years.

What are competency requirements? ›

Competencies often serve as the basis for skill standards that specify the level of knowledge, skills, and abilities required for success in the workplace as well as potential measurement criteria for assessing competency attainment. Competence is a measure of both proven skills and proven knowledge.

How do I know if I'm competent? ›

If someone can perform a required task at a targeted level of proficiency, they are competent. To be competent, you must be able to react to a situation and follow behaviors you have found to succeed in the past. To do this, you must have a repertoire of possible actions to take and training in them.

What are the levels of competence? ›

A consistent level of achievement to an appropriate standard is evidence of competence. Our Competency Framework recognises four levels of competence: Basic, Capable, Accomplished and Authoritative.

Is there a grace period for expired nursing license in Texas? ›

If you've submitted your renewal application by the last day of the month that your nursing license is set to expire, you have a grace period of one month. You can continue to practice nursing during this grace period, while your nursing license renewal is being processed by the BON.

How long does it take to get a blue card from Texas Board of Nursing? ›

The initial review can take up to 30 days. Correspondence will be sent by letter regarding the outcome of the initial review. Students who were asked for a D.O. and $150 fee must allow a minimum of 90 days for the Enforcement Department to send an outcome. Will my student receive a blue card if the D.O.

How do you know if you passed the NCLEX right away? ›

Upon completion of your NCLEX, if your nursing regulatory body participates in the Quick Results Service, you can access unofficial results two business days after the exam. Official results will be sent to you by your nursing regulatory body approximately six weeks after your NCLEX exam date.

How many hours do you have to work to keep your CNA license in Texas? ›

There is no expiration date printed on your certificate, but you are responsible to renew the certificate on your own. Within 2 years, you must complete 24 hours of in-service training and provide proof of qualifying employment in order to maintain an active status as you renew your CNA license in Texas.

Can a CNA work with an expired license in Texas? ›

Individuals that fail to renew by April 30, 2023, will no longer be eligible to work with an expired certificate on May 1, 2023. Check nurse aide registry status. We no longer provide written verification of Certified Nurse Aides. This website will assist with verifying the status.

Can a felon become an RN in Texas? ›

Criminal background checks are required of all applicants. Prior criminal convictions may cause one to be ineligible for licensure as a registered nurse. Applicants will be responsible for obtaining a background check and paying appropriate fees to be fingerprinted for the Texas Board of Nursing.

Can an RN work as an LVN in Texas? ›

One does not “substitute” for the other. If you have an active and unencumbered LVN license in addition to an RN license, then you can work as an LVN if you choose and if the state nurse practice act does not prohibit this.

How long is a Texas nursing license good for? ›

Your initial Texas license is valid for a period of 6-29 months, depending on your birth month and year. After your first renewal, your license will expire on the last day of your birth month, typically every 2 years.

How much is the endorsement fee for nursing license in Texas? ›

Application Fee: $150

(See Fee Schedule for more information.)

Can you take a year off nursing and go back? ›

The good news is that many nurses have successfully returned to work after time off. With a little preparation, you'll be ready to resume work as a nurse, even if you've been away for years. Here's what you need to consider as you prepare to return to nursing: Maintain your credentials.

How do I go back to nursing after a long break? ›

If you're planning to return to nursing, here's what George and other nursing leaders recommend:
  1. Research reentry requirements. Check with the state nursing association or board of nursing for your state's requirements for reentering the profession. ...
  2. Update your skills. ...
  3. Join a professional organization. ...
  4. Explore your options.

Can I take a year off from nursing? ›

Taking a Break from Nursing Is Okay

Keep in mind that taking a nursing break doesn't mean the end of your nursing career. In fact, many nurses have shared that taking a few months off from nursing can help restore mental health and reignite their passion for their jobs.

How many hours of continuing education are required for license renewal in DC? ›

If you are renewing for the first time, CEs are not required. Twenty Four (24) hours of continuing education (CE) every two (2) years, which includes 2 hours of LGBTQ, and 2.4 hours in Public Health Priorities.

How many hours of continuing education must a licensee complete for each year of licensure in Georgia? ›

Salespersons and Brokers in Georgia must complete 36 hours of continuing education each four-year license cycle. 3 of the 36 hours must be in Georgia License Law.

What is the purpose of incident based nursing peer review? ›

Incident-based nursing peer review focuses on determining if a nurse's actions, be it a single event or multiple events (such as in reviewing up to five (5) minor incidents by the same nurse within a year's period of time), should be reported to the Board or if the nurse's conduct does not require reporting because the ...

Why does the bon require nurses to disclose? ›

can be completed only by a registered nurse. Why does the BON require nurses to disclose that they have been diagnosed with, treated for, or hospitalized with certain mental illnesses? A. Nurses diagnosed with these disorders are required to not practice in psychiatric settings due to their mental health issues.


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