Texas Organization of Nurse Executives Conference Session

A mainstay and welcomed session at our annual conference is the update from the Texas Board of Nursing. Dr. Kristen Benton DNP, RN, Director of Nursing, presented the update again this year. Her presentation had three main objectives; discuss implications of the Enhanced Nurse Licensure Compact (eNLC), describe recent trends and regulatory updates relevant to nurse executives and discuss future regulatory activities of the Texas Board of Nursing. Dr. Benton’s slide presentation is available on the TONE website.

Discuss implications of the Enhances Nurse Licensure Compact (eNLC):

On January 19, 2018, the new eNLC went into effect. Twenty-four of the original 25 Nurse Licensure Compact states joined the eNLC. Five new states joined the eNLC and some at zero hour on January 19th. There are 11 requirements the State Boards must agree to prior to joining the eNLC. The requirement having the most disagreement among the States and led to last minute decision was the criminal background check. Some states did not want the checks but Texas was not one them. Nine more states have pending legislation to join the eNLC.

Describe recent trends and regulatory updates relevant to nurse executives:

Current Registered Nurse (RN) Licenses grew 4.2% from 2016 to 2017 for a grand total of 310, 509 RNs in Texas. Licensed Vocational Nurses (LVN) grew 1.7% over the same time frame. Texas now has 104,426 LVNs providing care today.

Complaints and disciplinary actions are still relatively small for 2017. Of the 414,935 nurses in the State of Texas, only 3,112 (0.75%) have complaints. Of those 3112 nurses, only 573 (18.4%) receive disciplinary action.

The Texas Board of Nursing had their Sunset review in 2017. Dr. Benton was happy to report it was over and it only comes around every 12 years.

During 2017 there were several rules adopted relating to nursing education and professional character. There are also several rules proposed for 2018 related to the reporting of minor incidents, peer review and safe harbor.

The Knowledge, Skills, Training, Assessment and Research (KSTAR) pilot program initiated in 2013 continues to be conducted by Texas A & M Health Sciences Center College of Nursing and the Rural and Community Health Institute. The program designs a personalized remedial education plan aimed at correcting any knowledge deficits that may exist in those nurses with practice violations that resulted in a disciplinary sanction of a warning and below. Monitoring and follow-up are built into the program.

Texas is one of three states with more than 10,000 first-time NCLEX-RN candidates. Sixty-six nursing programs in Texas have a >90% pass rate. Seven of those programs have 100%. Texas has 89.77% of Graduate Nurses pass the NCLEX which is better than the U.S. average of 86.94%

Discuss future regulatory activities of the Texas Board of Nursing:

There is significant research happening now on the NCLEX exam using sample questions. This research will be used to guide future NCLEX changes.

The continuing competency topic will be discussed this year by the Nursing Practice Advisory Committee and the Advanced Practice Nursing Advisory Committee will be discussing Chapter 221, Advanced Practice Nurses.

There will be a task force formed to study the implications of growth of nursing education programs in Texas.

A Chief Nurse Officer/Nurse Leader Board Rule Resource will be created to help new Nurse Leaders understand Board rules.

One may contact the Board at Webmaster@bon.texas.gov You may also call the Board at the following three numbers;

Practice: 512-305-6802

APRN Licensure: 512-305-6843

Education: 512-305-6816