The responsibility of the Texas Board of Nurse Examiners (board) is to regulate the practice of professional nursing within the State of Texas. The purpose of defining standards of practice is to identify roles and responsibilities of the registered professional nurse (RN) in any health care setting. The standards for professional nursing practice shall establish a minimum acceptable level of professional nursing practice. The RN shall:

1. (1) know and conform to the Texas Nursing Practice Act and the board's rules and regulations as well as all federal, state, or local laws, rules or regulations affecting the RN's current area of nursing practice;

2. (2) use a systematic approach to provide individualized, goal-directed nursing care by:

   1. (A) performing nursing assessments regarding the health status of the client;
   2. (B) making nursing diagnoses which serve as the basis for the strategy of care;
   3. (C) developing a plan of care based on the assessment and nursing diagnosis;
   4. (D) implementing nursing care; and
   5. (E) evaluating the client's responses to nursing interventions;
3. (3) know the rationale for and the effects of medications and treatments and shall correctly administer the same;

4. (4) accurately and completely report and document:

   1. (A) the client's status including signs, symptoms and responses;
   2. (B) nursing care rendered;
   3. (C) physician, dentist or podiatrist orders;
   4. (D) administration of medications, and treatments; and
   5. (E) client response(s);
   6. (F) contacts with other health care team members concerning significant events regarding client's status.
5. (5) implement measures to promote a safe environment for clients and others;
6. (6) respect the client's right to privacy by protecting confidential information unless obligated or allowed by law to disclose the information;
7. (7) promote and participate in client education and counseling based on health needs;
8. (8) ensure the verification of current Texas licensure and credentials of personnel for whom the RN is administratively responsible, when acting in the role of nurse administrator;
9. (9) make assignments to others that take into consideration client safety and which are commensurate with the educational preparation, experience, knowledge, and physical and emotional ability of the persons to whom the assignments are made;
10. (10) delegate nursing tasks in compliance with §218.3, relating to general criteria for delegation and §218.4, relating to supervision;
11. (11) supervise nursing care provided by others for whom the RN is administratively or professionally responsible;
12. (12) accept only those nursing assignments that take into consideration patient safety and that are commensurate with one's own educational preparation, experience, knowledge and physical and emotional ability;
13. (13) obtain instruction and supervision as necessary when implementing nursing procedures or practices;
14. (14) notify the appropriate supervisor when leaving a nursing assignment;
15. (15) know, recognize, and maintain professional boundaries of the nurse-client relationship;
16. (16) report unsafe nursing practice by an RN which a nurse has reasonable cause to suspect has exposed or is likely to expose a client unnecessarily to risk of harm as a result of failing to provide client care that conforms to the minimum standards of acceptable and prevailing professional practice. The RN should report unsafe practice conditions or other practitioners to the appropriate authority or licensing board;
17. (17) provide, without discrimination, nursing services regardless of the age, disability, economic status, gender, national origin, race, religion, or health problems of the client served;
18. (18) institute appropriate nursing intervention which might be required to stabilize a client's condition and/or prevent complications;
19. (19) clarify any order or treatment regimen that the nurse has reason to believe is inaccurate, non-efficacious or contraindicated by consulting with the appropriate licensed practitioner and notifying the ordering practitioner when the RN makes the decision not to administer the medication or treatment;
20. (20) implement measures to prevent exposure to infectious pathogens and communicable conditions;
21. (21) collaborate with the client, members of the health care team and, when appropriate, the client's significant other(s) in the interest of the client's health care;
22. (22) consult with, utilize and make referrals to appropriate community agencies and health care resources to provide continuity of care;
23. (23) be responsible for one's own continuing competence in nursing practice and individual professional growth.

Source Note:The provisions of this §217.11 adopted to be effective September 1, 1999, 24 TexReg 4001.