Texas Administrative Code
Title 22 - EXAMINING BOARDS
Part 11 - TEXAS BOARD OF NURSING
Chapter 222 - ADVANCED PRACTICE REGISTERED NURSES WITH PRESCRIPTIVE AUTHORITY
Section 222.10 - Enforcement

Universal Citation: 22 TX Admin Code § 222.10

Current through Reg. 50, No. 13; March 28, 2025

(a) Any APRN who violates the sections of this rule or orders or prescribes in a manner that is not consistent with the standard of care shall be subject to removal of the authority to order or prescribe under this section and disciplinary action by the Board. Behaviors associated with ordering and prescribing medications for which the Board may impose disciplinary action include, but are not limited to:

(1) ordering, prescribing, dispensing, or administering medications or devices for other than evidenced based therapeutic or prophylactic purposes that meet the minimum standards of care;

(2) ordering, prescribing, or dispensing medications or devices for personal use;

(3) failing to properly assess and document the assessment prior to ordering, prescribing, dispensing, or administering a medication or device;

(4) selling, purchasing, trading, or offering to sell, purchase, or trade a prescription drug sample;

(5) delegation of authority to any other person to order, prescribe, or dispense of an order or prescription for a drug or device; and

(6) failing to access and review the prescription monitoring program (PMP) authorized by Chapter 481, Health and Safety Code, before prescribing opioids, benzodiazepines, barbiturates, or carisoprodol, unless a statutory exemption contained in that chapter has been documented. If an APRN has made a good faith effort to comply with the requirement and is unable to do so because of circumstances beyond the APRN's control, documentation of this effort shall be made on the patient's prescription or in the patient's electronic prescription record.

(b) Failure to cooperate with a representative of the Board who conducts an onsite investigation may result in disciplinary action. Failure to cooperate with a representative of the Board or the Texas Medical Board who inspects and audits the practice relating to the implementation and operation of the prescriptive authority agreement may result in disciplinary action.

(c) The Board shall immediately notify the Texas Medical Board and the Texas Physician Assistant Board:

(1) when an APRN licensed by the Board becomes the subject of an investigation involving the delegation and supervision of prescriptive authority; and

(2) upon the final disposition of an investigation involving an APRN licensed by the Board and the delegation and supervision of prescriptive authority.

(d) Upon receipt of notice from the Texas Medical Board and/or the Texas Physician Assistant Board that a licensee of one of those boards is under investigation involving the delegation and supervision of prescriptive authority, the Board may open an investigation against an APRN who is a party to the prescriptive authority agreement with the licensee who is under investigation by the board that provided the notice.

(e) The Board shall report to the United States Drug Enforcement Administration any of the following:

(1) any significant changes in the status of the RN license or advanced practice license; or

(2) disciplinary action impacting an APRN's ability to authorize or issue prescription drug orders and medication orders.

(f) The practice of the APRN approved by the Board to order and prescribe is subject to monitoring by the Board on a periodic basis.

(g) The Board shall maintain a list of APRNs who have been subject to a final adverse disciplinary action for an act involving the delegation and supervision of prescriptive authority.

(h) The Board shall provide information to the public regarding APRNs who are prohibited from entering into or practicing under a prescriptive authority agreement.

(i) This section takes effect September 1, 2019.

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