Texas Register, Volume 38, Number 47, Pages 8313-8478, November 22, 2013 Page: 8,353
8313-8478 p. ; 28 cm.View a full description of this periodical.
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Fiscal Note. Kathy Thomas, Executive Director, has determined
that the first five-year period the proposed rules are in effect,
there will be no additional cost to state or local government(s),
as a result of enforcing or administering the sections.
Public Benefit/Cost Note. Ms. Thomas also has determined that
for each year of the first five-year period the rules are in effect,
the public benefit will be to clarify the requirements and process
for nurse delegation across varied professional nursing practice
settings. Ms. Thomas has determined that there will be no eco-
nomic cost to persons who are required to comply with the pro-
posed rules.
Economic Impact Statement and Regulatory Flexibility Analy-
sis for Small and Micro Businesses. The Government Code
2006.002(c) and (f) require that if a proposed rule may have
an economic impact on small businesses or micro businesses
state agencies must prepare, as part of the rulemaking process,
an economic impact statement that assesses the potential im-
pact of the proposed rule on these businesses and a regulatory
flexibility analysis that considers alternative methods of achiev-
ing the purpose of the rule.
The Government Code 2006.001(1) defines a micro business
as a legal entity, including a corporation, partnership, or sole
proprietorship that: (i) is formed for the purpose of making a
profit; (ii) is independently owned and operated; and (iii) has not
more than 20 employees. The Government Code 2006.001(2)
defines a small business as a legal entity, including a corpora-
tion, partnership, or sole proprietorship, that: (i) is formed for
the purpose of making a profit; (ii) is independently owned and
operated; and (iii) has fewer than 100 employees or less than
$6 million in annual gross receipts. Each of the elements in
2006.001(1) and (2) must be met in order for an entity to qualify
as a micro business or small business.
As required by the Government Code 2006.002(c) and (f), the
Board has determined that the proposed rules will not have an
adverse economic effect on any individual, Board regulated en-
tity, or other entity required to comply with the proposed rules
because no individual, Board regulated entity, or other entity
required to comply with the proposed rules meets the defini-
tion of a small or micro business under the Government Code
2006.001(1) or (2). The only entities subject to the proposed
rules are individual nurses. Because individual nurses are not
independently owned and operated legal entities that are formed
for the purpose of making a profit, no individual nurse qualifies as
a micro business or small business under the Government Code
2006.001(1) or (2). Therefore, in accordance with the Govern-
ment Code 2006.002(c) and (f), the Board is not required to
prepare a regulatory flexibility analysis.
Takings Impact Assessment. The Board has determined that
no private real property interests are affected by this proposal
and that this proposal does not restrict or limit an owner's right
to property that would otherwise exist in the absence of govern-
ment action and, therefore, does not constitute a taking or re-
quire a takings impact assessment under the Government Code
2007.043.
Request for Public Comment. Comments on the proposed
amendments and new rules may be submitted to James (Dusty)
Johnston, General Counsel, Texas Board of Nursing, 333
Guadalupe, Suite 3-460, Austin Texas 78701 or dusty.john-
ston@bon.texas.gov no later than 30 days from the date that
this proposal is published in the Texas RegisterStatutory Authority. The amendments and new rules are pro-
posed under Texas Occupations Code 301.151 and 301.152,
which authorize the Board of Nursing to adopt and enforce rules
consistent with the Nursing Practice Act, including rules address-
ing professional nursing practice and minimum standards of pro-
fessional nurse practice.
No other statutes, articles, or codes are affected by the proposed
rules.
225.1. Application of Chapter
(a) (No change.)
(b) If the situation does not meet the above criteria in subsec-
tion (a) of this section, any delegation of nursing tasks by the RN to an
unlicensed person must comply with [BNE] Chapter 224 of this title
(relating to Delegation of Tasks Relating to Acute Conditions or Set-
tings Other Than Independent Living Environments).
(c) (No change.)
225.2. Exclusions from Chapter.
This chapter does not apply to:
(1) - (2) (No change.)
(3) tasks performed under authority of Government Code
531.051(e) relating to Consumer Direction of Certain Services for
Persons With Disability and Elderly Persons [tasks provided in eem-
tutig the practice of professional nursing)];
(4) (No change.)
225.3. Purpose.
(a) The Texas Board of Nursing [Beard of Nurse Examiners]
(BON [BNE] or Board) recognizes that public preference in the provi-
sion of health care services includes a greater opportunity for clients to
share with the RN in the choice and control for delivery of services in
the community based setting. The Board also appreciates that the pro-
vision of health care is dynamic in nature and continually evolving. As
professional nurses, regardless of practice setting, RNs are obligated
to assess the nursing needs of the client, develop a plan of nursing ac-
tions, implement this plan, and evaluate the outcome. These are essen-
tial components of RN practice that identify professional nursing as a
process discipline. Professional nursing while inclusive of tasks is not
focused on tasks but rather on interventions or client-centered actions
initiated to assist the client in accomplishing the goals defined in the
nursing care plan.
(b) (No change.)
(c) The purpose of this chapter is to provide guidance to RNs
which includes advanced practice registered nurses practicing in in-
dependent living environments in incorporating the use of unlicensed
personnel to achieve optimal health benefits for the client. Clients in
these settings have needs that may be categorized as activities of daily
living (ADLs), health maintenance activities (HMAs), or nursing tasks.
For some clients, ADLs and HMAs may be of a routine and supportive
nature that minimizes the need for RN involvement.
(d) (No change.)
(e) The RN nurse administrator or the RN who is responsible
for nursing services in settings that utilize RN delegation in indepen-
dent living environments shall be responsible for knowing the require-
ments of this rule and for taking reasonable steps to assure that reg-
istered nurse delegation is implemented and conducted in compliance
with the Texas Nursing Practice Act and this chapter.PROPOSED RULES November 22, 2013 38 TexReg 8353
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Texas. Secretary of State. Texas Register, Volume 38, Number 47, Pages 8313-8478, November 22, 2013, periodical, November 22, 2013; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth379965/m1/41/: accessed July 17, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu.; crediting UNT Libraries Government Documents Department.