TEXAS CHRISTIAN UNIVERSITY
HARRIS COLLEGE OF NURSING &
HEALTH SCIENCES
NURS-BSN (pp. 2-62)
NURS-MSN (pp. 63-131)
STUDENT HANDBOOK
2013-2014
Revised 7/3/13
-1-
NURS-BSN Table of Contents
Content
Page
Welcome ........................................................................................................................................ 4
Harris College-Nursing ................................................................................................................... 4
Philosophy................................................................................................................................. 4
Program Goals .......................................................................................................................... 5
Accreditation and Licensure ...................................................................................................... 5
Student Abilities .............................................................................................................................. 6
Change in Health Status ................................................................................................................. 6
Student’s Responsibility ................................................................................................................. 7
Mid-Semester Grades .................................................................................................................... 7
Nursing Enrollment ......................................................................................................................... 7
Admission and Enrollment in the Nursing Major ..........................................................................7-9
Managing Nursing Practicum Enrollment ..................................................................................... 10
Nursing Prerequisites ................................................................................................................... 10
Nursing Progression Policies ...................................................................................................10-11
Graduation Policies ...................................................................................................................... 11
Policies for Accelerated BSN Track .............................................................................................. 12
Expectations of All Nursing Students in Concepts and Practica Courses…………………………13
Policy for Required Drug Testing and Criminal Background Screening .............................13-16
Pre-Clinical Dosage Calculation Testing Policy and Procedures .......................................17-19
Mathematical Rounding Policy for Drug Calculations .............................................................. 20
Guidelines for Reporting of Incidents ...................................................................................... 21
Attendance .............................................................................................................................. 21
Examinations........................................................................................................................... 22
Quizzes / Study Questions / Assignments............................................................................... 22
Formal Complaints……………………………………………………………………………………22
Classroom / Clinical Participation .......................................................................................22-23
Community Experiences – Personal Safety ............................................................................ 24
Medication Administration ....................................................................................................... 24
Professional Attire ..............................................................................................................24-25
TCU Harris College-Nursing Position Statement on Student Travel with Agency
Preceptors or Mentors ............................................................................................................. 26
Student Fees ................................................................................................................................ 26
Immunizations and Documentation Required Prior to Enrollment in Clinical Courses .............27-28
Required Health Insurance ........................................................................................................... 29
Health Insurance Portability and Accountability Act (HIPAA) Policies .....................................30-32
Student Completion of Training Regarding Harris College-Nursing Policies and Procedures
Regarding HIPAA .................................................................................................................... 33
Student Confidentiality Agreement (requires student’s signature) ................................................ 34
Student ID Card ............................................................................................................................ 35
Student Nurses’ Association ......................................................................................................... 35
Resources
Employment ............................................................................................................................ 35
Learning Center ...................................................................................................................... 35
Testing Program .................................................................................................................35-36
Sigma Theta Tau International ................................................................................................ 37
Honors Program ........................................................................................................................... 37
-2-
Professional Behavior ................................................................................................................... 38
Professional Conduct Statement ............................................................................................. 38
Unsafe Nursing Practice ......................................................................................................... 39
Code of Ethics for Nurses ..................................................................................................39-40
Bloodborne Pathogens Exposure ................................................................................................. 41
Use of Standard Precautions ........................................................................................................ 42
Advising
What a Student Can Expect From an Adviser ......................................................................... 43
What an Adviser Can Expect from the Student ....................................................................... 44
BSN Degree Requirements – Nursing Prerequisites…………………………………………….45
Core Curriculum Diagram Grid for University Requirements ................................................... 46
BSN Suggested Plan of Study ................................................................................................ 47
BSN Suggested Plan of Study for Army ROTC ....................................................................... 48
BSN Suggested Plan of Study for Air Force ROTC................................................................. 49
BSN Suggested Plan of Student for Honor Students .........................................................50-51
BSN Suggested Plan of Study for Students Planning to Study Abroad……………………….52
Accelerated BSN Track ................................................................................................................ 53
How to Graduate on Time .......................................................................................................54-55
Harris College of Nursing & Health Sciences Academic Action / Special Permission .............57-59
Disability Support Services ........................................................................................................... 60
The William L. Adams Center for Writing ...................................................................................... 61
Texas Board of Nursing………………………………………………………………………………… 62
-3-
4
WELCOME
Welcome to Texas Christian University (TCU) and the Harris College of Nursing and Health Sciences
Baccalaureate of Science in Nursing (BSN) program. During the next several semesters you will
learn the art and science of professional nursing, gaining career skills designed to carry you well into
the 21st century. The Harris College-Nursing BSN Student Handbook contains the policies and
procedures that apply to nursing students at TCU. The Handbook also introduces the standards of
professional nursing. In order for Harris College-Nursing to provide the best educational preparation
for you, all of us—faculty, staff, and students—are accountable for the information contained in the
Handbook.
We value your choice to become a student in our program, recognizing the privilege and
responsibility you have granted us. Welcome to Harris College-Nursing.
HARRIS COLLEGE-NURSING ♦
Harris College-Nursing endorses the Mission and Vision of TCU. The specific mission of the BSN
program is to prepare professional nurses to identify and respond with competence to multiple,
complex human health-care needs. Graduates serve society through professional nursing roles and
provide ethical leadership in practice, administration, teaching and scholarship. The nursing program
is dedicated to professional nursing education based on a foundation of sciences, and humanities
and to the promotion of an environment that encourages lifelong learning. The College further
affirms a commitment to professional competence and civic and professional responsibilities
in a global society. The nursing program is designed to meet the needs of high school graduates,
transfer students, and registered nurses interested in obtaining the BSN degree.
Philosophy
The faculty of Harris College-Nursing, an academic unit of TCU, affirms that individuals are holistic
beings who possess inherent worth. The faculty believes that the education of the professional nurse
should prepare a graduate who exhibits qualities of mind and character that are necessary to live a
fulfilling life, act in the public interest locally and globally, and promote health and the nursing
profession. The teaching/ learning process is multidimensional and interactive, involving affective,
cognitive and psychomotor changes. A liberal educational foundation assists persons to think
critically and to seek improvement in themselves, the profession, and society. A liberal education
provides the basis for the development of core competencies and knowledge of professional
nursing. The Harris College-Nursing faculty embraces the professional values of altruism,
autonomy, human dignity, integrity, and social justice. Nursing practice, conduct, and relationships
are guided by professional standards and the ANA Code of Ethics. Sound clinical judgments
characterize the practice of the professional nurse in providing safe, humanistic care of individuals,
families, and groups in and across diverse environments.
Portions of the above are based on the current Essentials of Baccalaureate Education for
Professional Nursing Practice, published by the American Association of Colleges of Nursing,
Washington, DC.
♦ Does not apply to graduate students. See additional information in the graduate section of this
handbook.
5
Program Goals
The program goals of Harris College-Nursing are as follows:
• Prepare graduates who are competent to meet the unique, multiple, and complex human health
needs of a global society.
• Promote values and behaviors that encourage respect for diversity, acknowledge human worth
and dignity, and support professional nursing practice.
• Foster an appreciation for the necessity of learning, thinking critically, and continuing to grow
personally and professionally.
• Contribute to the nursing profession and to society by engaging in scholarship, leadership, and
service.
• Support the University’s mission, vision, core values, and goals.
Accreditation and Licensure
The College enabled by a trust fund established by the late Dr. Charles Houston Harris, was
organized as an academic unit of TCU in 1946. Harris College-Nursing BSN and MSN programs are
fully accredited by the Texas Board of Nursing (BON). BSN graduates are eligible to write the
examination for licensure as a registered nurse (R.N.) in Texas or any other state in the United
States. Successful completion of the National Council Licensure Examination in one state qualifies
graduates to apply for licensure in any other state.
Harris College-Nursing, BSN Program achieved national accreditation in 1952 and has remained
fully accredited since then by either the Texas Board of Nursing (BON), 333 Guadalupe, #3-460,
Austin, TX, 78701, 512-305-7400 or the Commission on Collegiate Nursing Education (CCNE), One
DuPont Circle, NW, Suite 530, Washington, DC, 20036-1120, 202-463-6930. The MSN program was
granted full accreditation in May 2003 by the Commission on Collegiate Nursing Education (CCNE)
and has remained fully accredited since then.
In compliance with the policy of the BON, all applicants are informed that completion of the BSN
degree does not guarantee eligibility for the registered nurse licensure examination. Professional
character is necessary for an individual to conform to the requirements of the Nurse Practice Act.
Individuals should seek special advising prior to enrolling in any professional nursing program in
Texas if they have a personal history involving conditions that may endanger the health and safety of
a person. These include: (1) denied licensure or had disciplinary actions by any licensing authority in
any state, country, or province, (2) convicted or received a deferred order, with or without adjudication
of guilt for a felony or misdemeanor, (3) diagnosed, treated, or hospitalized in the past five years for
schizophrenia or other psychotic disorders, bipolar disorder, paranoid personality disorder, antisocial
personality disorder, or borderline personality disorder, or (4) addicted or treated for use of alcohol or
any other drug within the past 5 years (BON, excerpts from the Rules and Regulations Relating to
Professional Nurse Education, Licensure and Practice, www.bon.state.tx.us. Further licensure
information is available in the office of the Director, Harris College-Nursing, TCU Box 298620, Fort
Worth, TX 76129. In compliance with the Americans with Disabilities Act (ADA), a description of the
abilities required for admission to and completion of the BSN curriculum follows.
6
STUDENT ABILITIES
In support of the 1973 Americans with Disabilities Act the faculty of Harris College-Nursing
has defined the scope of nursing as it applies to the disabled or rehabilitating student.
(Approved by the Faculty of Harris College-Nursing, December 2000.)
To enter, remain and progress in the nursing program, all students must have the following
abilities. Examples of abilities listed below are not inclusive.
•
•
•
•
•
•
•
Students must have sufficient physical mobility to travel independently to and within hospitals,
homes, clinics, schools, and other health-related agencies. They must have the gross and fine
motor capability to provide safe care to clients independently. This requires the ability to sustain
work requiring delivering services at the bedside, standing/walking for 8-12 hours, traveling
independently, reaching, bending, lifting up to 50 pounds, and quick movements.
Students must have sufficient tactile and manual dexterity to (a) accurately manipulate
equipment, (b) complete a physical assessment (palpation, percussion, auscultation), (c) prepare
and administer medications, (d) legibly print dates and times on medication vials, (e) perform
cardiopulmonary resuscitation, (f) use a computer keyboard, (g) legibly and accurately document
nursing care, and (h) perceive attributes of objects such as dimension, shape, temperature or
texture.
Students must have sufficient visual acuity to (a) observe subtle changes in clients’ conditions,
(b) accurately read medical records and orders, (c) accurately read a computer monitor screen,
and (d) legibly and accurately document nursing care.
Students must have the auditory acuity with and without background noise that enables them to
assess the physical status of a client (breath sounds, heart sounds, etc.).
Students must possess sufficient sensory function to recognize alarm and telephone signals.
Students must have sufficient receptive, written and oral communication skills to accurately
receive, read, interpret and comprehend the English language in written and verbal forms in order
to (a) to communicate effectively and professionally with clients, faculty, staff, and peers from a
variety of social, emotional, cultural and intellectual backgrounds; (b) teach clients and families;
(c) accurately document, interpret, and comprehend nursing interventions and actions and client
responses; and (d) communicate data about clients in a timely manner.
Students must have sufficient emotional stability and cognitive skills to (a) process information in
a reasonable amount of time; (b) make clinical judgments accurately; (c) identify cause and effect
relationships in clinical situations; (d) establish and maintain appropriate relationships with
clients, faculty, staff, and peers; and (e) have adequate environmental awareness in multiple,
complex settings that may be stressful and noisy and may be potentially harmful. This includes
exposure to communicable diseases, personal injury, death of patients, and violence in the
workplace.
CHANGE IN HEALTH STATUS
Students who experience a change in their health status that affects their ability to function safely or
meet course objectives in the practicum and/or classroom setting must notify their assigned faculty.
The faculty member may require documentation from the student’s health care provider indicating the
student’s functional abilities and/or limitations.
7
STUDENT’S RESPONSIBILITY
The faculty and academic advisers are available to help students understand and meet academic
requirements for a degree, but the students themselves are responsible for understanding and
fulfilling the requirements. The degree cannot be awarded until all requirements as defined by the
Bulletin are met. It is essential that each student become familiar with all requirements and remains
informed throughout the program career.
MID-SEMESTER GRADES
After mid-semester grades are received, the faculty will identify students attaining unsatisfactory
progress in any course. Students will be sent an academic and/or clinical warning letter from the
Registrar. It is the student’s responsibility to seek the assistance necessary to successfully complete
the course in question.
NURSING ENROLLMENT ♦
Nursing enrollment policies appear in the current TCU Undergraduate Studies Bulletin, which can be
found at: http://catalog.tcu.edu/undergraduate/index.asp. The Harris College-Nursing policies
appear in the Harris College of Nursing and Health Sciences (HCNHS) section of the Bulletin.
The current TCU Undergraduate Studies Bulletin contains policies specific to University academic
probation and suspension.
ADMISSION AND ENROLLMENT IN THE NURSING MAJOR ♦
A. TCU Continuing Students (entered TCU as a freshman; major-nursing). Continuing TCU
nursing majors should file an Intent to Enroll in First Practicum Courses by October 1 for the
spring semester and February 1 for the fall semester. Forms are available in the Harris CollegeNursing administrative office.
B. Change of Major Students (entered TCU as a freshman; major other than nursing)
1. A TCU student may change to the nursing major if the student is not on academic warning or
probation and has at least a 2.5 TCU cumulative GPA. The student must meet the requirements
for graduation based upon the published TCU Bulletin at the time of entry into the major.
2. Completion of the Change of Major Form: The Change of Major form must be completed at
least one semester prior to the first semester of nursing practicum courses. It is strongly
recommended that the change of major form be completed as soon as possible. Change of major
students must meet with a nursing advisor before the change of major form will be processed by
HCN-Nursing.
3. Completion of the Intent to Enroll in First Practicum Courses: The Intent to Enroll in First
Practicum Courses form must be filed by February 1 for the fall semester and October 1 for the
spring semester prior to practicum coursework. Permission to enroll in practicum courses
depends on the availability of clinical placement slots in clinical facilities.
8
C. Transfer Students (a student who has been out of high school for at least one full
semester and has attempted college or university work elsewhere for credit).
1. Transfer students must apply for admission to TCU and the nursing program. Individuals who
plan to apply as transfer students are urged to contact the TCU Admission Office and Harris
College of Nursing and Health Sciences nursing program in order to receive current information.
The number of new transfer students admitted to practicum courses each semester depends on
the availability of faculty, facilities, and the number of qualified continuing TCU students.
Selection of transfer students for initial entry into practicum courses also is based upon indicators
of the applicant’s likelihood of success in the nursing program and in professional practice.
2. Transfer students will not be permitted to pursue a nursing major at TCU if they have been
previously enrolled in another nursing program and were not in good standing upon exit or are
not eligible for readmission to the previous program(s). Transfer student applicants who have
been previously enrolled in a nursing program must submit, as part of their application, a letter
from the dean or director of that nursing program indicating they meet eligibility for readmission.
3. Deadlines for application for initial entry into practicum courses by transfer students are
February 1 for the fall semester and October 1 for the spring semester.
4. Admission Assessment (A2) scores are required with the application. Transfer applicants are
advised to contact the Harris College-Nursing as early as possible in the application process.
D. Accelerated BSN Track for Non-Nurse College Graduates. Harris College of Nursing and
Health Sciences offers an accelerated BSN track for non-nurses with bachelor degrees in other
fields. The program features a unique sequence of practicum courses that maximize clinical
inquiry and role transition. Partnerships with regional health care systems provide students with
a solid grounding in professional nursing practice. The 15-month course of study is full-time.
Students begin the program in mid-May and graduate mid-August of the next year. Applicants
must hold a previous baccalaureate degree and possess a GPA of 3.00 or higher to meet
eligibility. Admission is competitive; based on academic record, entrance exam scores, and
completion of all prerequisite courses and TCU core requirements. Students must also comply
with other admission requirements as listed above. Those interested should contact the Harris
College-Nursing for admission requirements unique to this program.
E. Other
Reenrollment – The student who has been a nursing major and leaves TCU must apply for
reenrollment after an absence of a full fall or spring semester. If the student meets enrollment
criteria, the Registrar’s Office will contact the Harris College-Nursing to receive approval for the
student to reenroll as a nursing major. The student must meet the requirements for graduation
based upon the published TCU Bulletin at the time of reentry into the nursing major. Reentering
students may be required to pass comprehensive mastery exam(s). Reenrollment depends on
clinical space availability in practicum courses.
Additional Bachelor’s Degree – A student with a previous undergraduate degree from TCU must
meet the same enrollment requirements as other TCU students. A student with a Bachelor’s
degree from another university is considered a transfer student.
F. Enrollment Requirements for Clinical Coursework. Once admitted to the nursing program,
students must meet calendar deadlines for application to enroll in practicum courses.
• The following prerequisite courses must be completed with a grade of "C" or higher before
entering the first practicum nursing courses. Students taking nursing prerequisites who make
a C- which equates to a grade point of 1.67 will not meet the nursing program’s entrance
criterion.
9
Anatomy & Physiology I (BIOL 20204 / Lab) ............................................................. 4
Anatomy & Physiology II (BIOL 20214 / Lab ............................................................. 4
Microbiology (BIOL 20233 / Lab) .............................................................................. 3
Lifespan Growth and Development (NURS 10303) .................................................. 3
Introductory Psychology (PSY 10213) ...................................................................... 3
Introductory Sociology (SOCI 20213) ....................................................................... 3
Math - Elementary Statistics (MATH 10043) ............................................................. 3
Nutrition (NTDT 20403) ............................................................................................. 3
It is recommended that students have no more than 18 credit hours of TCU CORE Curriculum
(TCU CC) that have not been completed. Enrollment in all nursing courses limited to the nursing
major requires at least a 2.5 TCU cumulative GPA. Students who show an inability to achieve or
maintain a 2.5 GPA prior to enrollment in practicum courses may be discontinued from the major.
• Current cardiopulmonary resuscitation (CPR) for healthcare provider’s card
• Documentation of required immunizations (contact Harris College-Nursing for list)
• Completion of Admission Assessment Exam (A2) (contact Harris College-Nursing to schedule
– continuing and transfer students must submit scores with application). Students may take the
A2 once in a 12 month period.
• Documentation of health insurance
• Drug screen and criminal background check as required by health care agencies
10
MANAGING NURSING PRACTICUM ENROLLMENT ♦
Nursing practicum courses will be listed on the class schedule and available for online enrollment
during advance enrollment through the end of the semester. When necessary, the status of all
practicum courses will be changed to ―dept. permit‖. Once the status is changed to ―dept. permit‖
permission numbers to enroll in and/or change practicum sections will only be given with approval of
the Harris College-Nursing Director, lead teacher and/or practicum instructor so that section
enrollment numbers can be more evenly dispersed.
NURSING PREREQUISITES
Nursing prerequisite courses must be completed with a grade of ―C‖ or higher before entering the
first practicum nursing courses. Students taking nursing prerequisites who make a C- which equates
to a grade point of 1.67 will not meet the nursing program’s entrance criterion.
Transfer of Nursing Prerequisite Courses
TCU students completing prerequisites Anatomy and Physiology I, Anatomy and Physiology II,
and/or Microbiology at other facilities must follow the University’s Transfer Credit Policy and Harris
College--Nursing policy that these courses be completed at an approved four year institution.
NURSING PROGRESSION POLICIES ♦








Enrollment in all nursing courses limited to the nursing major requires at least a 2.5 TCU
cumulative GPA.
Students may repeat one nursing course if less than a ―C‖ or a ―No Credit‖ (NC) grade is earned.
Students are discontinued from the major if grades of ―D‖, ―F‖, or ―NC‖ are earned in two or more
nursing courses (excluding NURS 10303, 10043, and 20033). This policy applies even though
the grade of ―D‖, ―F‖ or ―NC‖ has been replaced by a passing grade achieved by retaking a
course.
Students who are repeatedly unable to achieve or maintain a 2.5 GPA are discontinued from the
major.
All Nursing Progression Policies apply to students enrolled in the Accelerated BSN track.
All ABT students must maintain at least a 2.5 cumulative nursing GPA each semester to progress
in the ABT nursing program.
Students may be discontinued from the nursing major when their academic, practicum, or
personal performance is determined to be inconsistent with professional responsibility and
accountability. In rare instances, the safety of patients may necessitate removal of a student
from practicum. Faculty members are responsible for recommending this action to the Director of
the nursing program when indicated.
As a minimum requirement for participating in a practicum, students’ performance must be in
compliance with the Nursing Scope and Standards of Practice published by the ANA and the
Texas Board of Nursing’s Rules and Regulations including‖…not accepting an assignment when
one’s physical or emotional condition prevents the safe and effective delivery of care…‖. When
in the opinion of the instructor a student is not prepared for the educational activity or is in
violation of these rules for any reason, including but not limited to, impairment by reasons of
alcohol and/or drug abuse, the student is dismissed from practicum for the day by the instructor.
The instructor may recommend further action to the Director.
11


Beginning in fall 2007 freshmen may be subject to + / - grading campus-wide. TCU cumulative
GPA of 2.5 is required for enrollment and progression in nursing courses. Students taking
prerequisites who make a C- which equates to a grade point of 1.67 will not meet the nursing
program’s entrance criterion.
All clinical students who have successfully completed the pharmacology course must pass a 20item dosage calculation test by the end of the first week of each clinical semester. Students have
two attempts to pass, the passing score is 90% or above. If a student is unsuccessful,
completion of NURS 30331 Dosage Calculations for Nurses is required for a student to remain in
clinical coursework.
GRADUATION POLICIES ♦
Requirements for Graduation. For the Bachelor of Science in Nursing degree a student must have:
 A 2.0 cumulative GPA for all coursework completed at TCU.
 Completed all nursing courses required for the major with grades of ―C‖ or higher.
 Completed all TCU Core requirements.
Multiple Majors. Nursing students may, with prior approval of appropriate academic deans, pursue
an additional major concurrent with nursing. Such students must declare nursing as the first major
and complete all degree requirements for both nursing and the additional major. Students interested
in this option are encouraged to meet with advisers from both majors as soon as possible to develop
an academic plan.
♦ Does not apply to graduate students. See additional information in the graduate section of this
handbook.
12
POLICIES FOR ACCELERATED BSN TRACK
Meeting Prerequisites and TCU Core Requirements
Students must meet all prerequisites and TCU core requirements prior to consideration for
admission. Applicants enrolled in prerequisite courses at the time of application should include
evidence of satisfactory progress in those courses with their application for admission.
Consideration may be extended to exceptional applicants who do not meet the religion requirement;
however, students must complete this requirement prior to graduation. In some circumstances,
graduation and eligibility to take NCLEX may be delayed until requirements are met.
Progression
All progression policies for the Traditional Program also apply to students enrolled in the ABT track.
Failing or Dropping a Course
A student who fails or drops one or more courses cannot continue in (or be readmitted to) the ABT.
See the policy: Transitioning from ABT to Traditional Program.
Transitioning from Traditional Program to ABT
Students in the traditional program who possess a baccalaureate degree may be eligible to transition
into the ABT on a space available basis. These students must apply to the ABT and meet all
requirements for admission. Traditional students may transition to ABT during the Fall semester
only. Students must have completed NURS 10043, NURS 20033, NURS 20163, NURS 20224,
NURS 20284, and NURS 40053. For ABT transition in the spring semester, students also must
have completed NURS 30714, NURS 30783, NURS 30813, NURS 30882, NURS 40312, NURS
40382, and NURS 40632.
Transitioning from ABT to Traditional Program
If an ABT student fails only one course, cannot progress with < 2.5 GPA, or elects not to continue in
the ABT, then that student may transition from the ABT to traditional BSN program on a space
available basis. See the policy: Failing or Dropping a Course.
♦ Does not apply to graduate students. See additional information in the graduate section of this
handbook.
13
EXPECTATIONS OF ALL NURSING STUDENTS IN CONCEPTS AND PRACTICA COURSES
Policy for Required Drug Testing and Criminal Background Screening (effective fall 2003) ♦
Drug testing and criminal background checking of nursing students is required by the facilities which
are the sites for the clinical learning experience of nursing students of TCU, Harris College-Nursing.
These facilities require drug testing and criminal background checking of each student, prior to the
time the student would have contact with the facility’s patients or employees, under the November
2000 Community Standards for Drug Testing and Background Screening developed by a task force
of members of the Dallas-Fort Worth Hospital Council [―Community Standards‖]. According to the
Community Standards, the rationale for the drug testing and criminal background checking is due
diligence and competency assessment of students whose assignments bring them in contact with
patients or employees. Before a nursing student can be placed by Harris College-Nursing facility for
his/her clinical experience, the student must have certain acceptable results on both a drug test and
a criminal background check. Therefore, Harris College-Nursing requires drug testing and criminal
background checking of all students in its nursing program as explained below.
Harris College-Nursing Selection of Company to perform Drug Testing/Criminal Background Check ♦
Harris College-Nursing will notify students of the company designated by Harris College-Nursing to
perform the drug testing and criminal background check. Harris College-Nursing will not accept drug
test and criminal background check results from any company other than the one designated by
Harris College-Nursing. Harris College-Nursing will only accept results from the designated
company for drug tests and criminal background checks provided for under this policy. For example,
Harris College-Nursing will not accept a drug test/criminal background check which a student has
independently obtained from the company outside the procedure provided in this policy.
The company selected is independent and separate from both TCU and Harris College-Nursing. It is
not and shall not be considered a partner, joint venturer, employee, or agent of TCU or Harris
College-Nursing. TCU shall not be considered a partner, joint venturer, employee, or agent of the
company.
At the time of the drug testing/criminal background check, the student is required to pay the cost. It
is billed to TCU account after the 12th day of semester.
Drug Screening Test ♦
A. Harris College-Nursing Students Required Drug Screening Test/Timing of Drug Screening Test
Harris College-Nursing students enrolled in clinical coursework for the first time or a student who has
had a break in enrollment in clinical courses are required to complete a drug screening test at a time
designated by Harris College-Nursing prior to the first clinical day in the facility. A break in
enrollment is defined as non-enrollment for one full semester or more in clinical coursework. Refer
to TCU’s Student Handbook on Alcohol and Drug Abuse Policies and Penalties.
B. Drug Test Procedure/Requirements
The company Harris College-Nursing selects to perform the urine drug tests will be scheduled to be
on campus on a specified day prior to the beginning of clinical coursework each semester to obtain
and test urine samples from each student. Each student required to undergo the drug test shall
cooperate in all aspects the urine drug test and to complete the drug test on campus on the day
specified by Harris College-Nursing. Each student is required to sign any and all consents/releases,
in the form(s) designated by Harris College-Nursing, including consent to the drug test and
permission for the results of the drug test to be provided to TCU and Harris College-Nursing. It is a
violation of this policy for a student to adulterate or attempt to adulterate a specimen, to engage in
14
any deceptive behavior during or in connection with the testing process, or take any other action
which would falsify test results or tend to make test results inaccurate.
♦ Does not apply to graduate students. See additional information in the graduate section of this
handbook.
As part of the drug testing procedure, the student may be contacted by the Medical Review
Officer [―MRO‖] affiliated with the testing company. The student should cooperate with and
accurately respond to inquiries of the Medical Review Officer.
A positive drug screen for a student is defined under this policy to be one reported as such by
the testing company selected by Harris College-Nursing. Generally, under the Community
Standards, this refers to the testing company indicating the student tested on both the company’s
initial test and GC/MS confirm test as outside the acceptable range set by the testing company,
and with the MRO not determining the test result should be a negative. A negative test for a
student is defined under this policy a test result which is not a positive test result.
C. Reporting of Drug Test Results to Harris College-Nursing
The testing company will communicate the drug test results to the Director of Harris CollegeNursing. It is the policy of TCU and Harris College-Nursing to maintain the confidentiality of these
drug test results to the extent required by law.
D. Consequences
When a positive drug screen occurs, the following will occur:
• the student will be immediately suspended for a minimum of one year (12 continuous months
from the date of the beginning of the suspension) from the nursing program; and
• the positive drug screen will be shared by Harris College-Nursing with the TCU Dean of
Campus Life for further action, including but not limited to referral for a drug abuse education
program, referral to counseling, and/or referral to a drug treatment program, under TCU’s
institutional policies; and
• other appropriate action, if any.
Any nursing student with a positive drug screen is encouraged to seek treatment.
TCU Nursing encourages impaired students to seek assistance voluntarily and assume
responsibility for their personal and professional conduct.
A student who has on one occasion had a positive drug screen under this policy, and who
desires to reapply to TCU’s Nursing, may reapply only for a school semester beginning after the
period of suspension (one year minimum). The student will, in addition to meeting all other
requirements for similarly situated applicants, be required to provide documentation of successful
treatment and the student will be required to consent to and undergo a retest, at a time and
through a testing company selected by Harris College-Nursing, with this retest resulting in a
negative drug screen. This re-testing is at the student’s expense. The decision on whether to readmit the student is not guaranteed, and will be made on a case-by-case basis.
E. Estimated Cost of Drug Screening Test
Approximately $45.00. The cost of the drug screen is the student’s responsibility.
F. Suspicion Testing Under the Community Standards
Additionally, the Community Standards provide that a student assigned to a facility for a clinical
experience, and who is suspected by the facility or faculty of substance use or abuse, will be
asked to consent to a drug test, plus other consequences. In this situation, the student is
required to sign the consent and complete an immediate drug test as provided by the Community
Standards.
15
Criminal Background Check ♦
A. Harris College-Nursing Students required to have Criminal Background Check/Timing of criminal
background check:
Harris College-Nursing students enrolled in clinical coursework for the first time or a student who
has had a break in enrollment in clinical courses is required to complete the criminal background
check at the time designated by Harris College-Nursing prior to the first clinical day in the facility.
A break in enrollment is defined as non-enrollment for one full semester or more in clinical
coursework.
♦ Does not apply to graduate students. See additional information in the graduate section of this
handbook.
B. Criminal Background Check Procedure/Requirements
Each student who will be the subject of the criminal background check is required to cooperate
with the company conducting the check so that it can be completed at the time required by Harris
College-Nursing prior to the student contacting patients or employees at the facility. Each
student is required to provide the screening company accurate identifying information requested
so that the company can carry out the screen upon the student. Each student is required to sign
any and all consents/releases, in the form(s) designated by Harris College-Nursing, including
consent to the criminal background check and permission for it to be provided by the company to
TCU and Harris College-Nursing. It is intended that the background check include all cities and
counties of known residence for the 7-year period prior to the check.
Under this policy, the term ―failing‖ the criminal background check is defined as the screening
company reporting to Harris College-Nursing that the student had any of the following, during the
7 year period prior to the check:
 A felony conviction.
 A misdemeanor conviction or felony deferred adjudication involving a crime against a person
(physical or sexual abuse).
 A misdemeanor conviction related to moral turpitude (prostitution, public lewdness/exposure,
etc).
 A felony deferred adjudication for the sale, possession, distribution, or transfer of narcotics or
controlled substances.
 Registration as a sex offender.
C. Reporting of Criminal Background Check to Harris College-Nursing
The company conducting the criminal background check will communicate the criminal
background check results to the Director of Harris College-Nursing. It is the policy of TCU and
Harris College-Nursing to maintain the confidentiality of these criminal background check results
to the extent required by law.
D. Consequences
When a student fails the criminal background check, the following will occur:
1. The student will be immediately suspended from practica courses (but may remain in
concept/classroom courses) until the earlier of the following: (a) the company conducting the
check reports to Harris College-Nursing (perhaps through clarifying information provided by
the student to the company) that the student no longer fails the check, or (2) the student
obtains from the Texas Board of Nursing a Declaratory Order or similar decision stating the
individual is eligible for initial licensure or licensure renewal.
2. The student will be notified of a description of the adverse action taken, the name of the
company which prepared the report, a statement that the company did not make the decision
16
to take the adverse action, that the student has a right to obtain a free copy of the company’s
report from the company, and to contest its contents.
3. The results will be shared by Harris College-Nursing with the TCU Dean of Campus Life for
further action under TCU’s institutional policies.
4. Other appropriate action, if any.
A student who is convicted of or receives deferred adjudication for any of the criminal offenses
referred to in Section B above while enrolled in the program must report the conviction to the
Director of Harris College-Nursing, within three days of the conviction, and the student will be
referred to the TCU Dean of Campus Life and suspended from the nursing program until the
student obtains from the Texas Board of Nursing a Declaratory Order or similar decision stating
the individual is eligible for initial licensure or licensure renewal.
E. Estimated Cost of the Criminal Background Check
Approximately $45.00. The cost of the criminal background check is the student’s responsibility.
TCU’s Institutional Policies/Policies of Other Departments or Programs ♦
TCU has separate and additional Institutional policies which may provide additional requirements,
disciplinary action, and/or consequences applicable to events and occurrences covered by the Harris
College-Nursing policy.
In addition, some other programs or departments at TCU have, or in the future may have, drug
test and/or criminal background check policies or procedures. These other policies and procedures,
and their terms, conditions, requirements, disciplinary action and/or consequences are in addition to
those in this Harris College-Nursing policy.
See the TCU Student Handbook, which provides additional information about on-campus services
and health risks associated with drug and alcohol abuse. Refer to TCU’s Student Handbook on
Alcohol and Drug Abuse Policies and Penalties.
17
Pre-Clinical Dosage Calculation Testing Policy and Procedures (approved January 2002;
revised April 2005; revised September 2008) ♦
Purpose: The Pre-Clinical Nursing Dosage Calculation Testing Policy exists to facilitate dosage
calculation competence necessary for safe nursing practice. The nursing literature reports that the
majority of nursing errors occur in medication administration. Many hospitals require nurses to
demonstrate dosage calculation proficiency as a requirement for employment.
Therefore, it is imperative that nursing students assume personal responsibility for maintenance
of dosage calculation skills throughout the nursing curriculum. The dosage calculation testing serves
as a means for continued assessment by students and faculty of these important required skills.
TCU Nursing is committed to assisting students who need additional instruction in dosage
calculations in order to maintain safe medication administration in clinical courses.
Resources available to assist students to prepare for the dosage calculation tests include:
1. a study packet e-mailed to all students prior to testing
2. a review for students who are unsuccessful on first test, prior to second test attempt
3. sample tests available from the lead instructor of the pharmacology lab course upon request
4. assistance from the Assistant Director of Recruitment and Retention to identify a tutor
5. a computer software program available on the computers in the nursing computer lab
6. TCU nursing will identify a dosage calculation, self study software program that the students may
purchase
Policy
All clinical students who have successfully completed the pharmacology course must pass a 20-item
dosage calculation test by the end of the first week of each clinical semester. The student has two
attempts to pass the test; the passing score is 90% or above.
Should a student be unsuccessful in both testing attempts, TCU Nursing will require that student
to be enrolled in NURS 30331 Dosage Calculations for Nurses, a directed study, one semester credit
hour course composed of six modules. NURS 30331 is to be completed within fourteen (14) days
after enrollment. NURS 30331 is a pass/no credit course.
Successful completion of this course requires passing a 20-item dosage calculation test at a 90%
or above proficiency within two attempts. Students not meeting this standard will be dropped from
clinical courses.
♦ Does not apply to graduate students. See additional information in the graduate section of this
handbook.
18
Procedure
Pre-Clinical Dosage Calculations Testing Procedures ♦
Test Description
There will be 20 items on each test. Test items will be composed of dosage calculation problems
focusing on various routes of medication, i.e. oral and/or topical, non-IV injectables and intravenous.
Some test items will require the use of mathematical conversions and rounding of decimals
(according to the TCU Nursing Mathematical Rounding Rule Policy for Drug Calculations) for
accurate completion.
Standard Testing Times
Standard Testing times are listed in the semester Orientation Schedule. Students are to refer to the
schedule for their assigned testing time. Students requiring special accommodations must submit
the appropriate paper work to the Learning Center Coordinator before the assigned testing date.
Fall Semester:
Testing times will be scheduled during the first week of classes and will be listed on the orientation
schedule.
Spring Semester: Testing times will be scheduled during the first week of classes and will be listed
on the orientation schedule. Students who have successfully passed pharmacology in the fall
semester are exempt from taking the dosage calculation exam the following spring.
Second attempt testing and review
Students who failed the first test will be able to review their test at a designated time prior to the
―second attempt test‖ date. The ―second attempt test‖ will be on the Friday of the first week of the
semester or as otherwise noted on the orientation schedule.
Administration of the Test ♦
The testing format will be paper and pencil or by computer. Students are to bring their TCU student
ID, a #2 lead pencil and a calculator. Only calculators that do not have the ability to store data will be
permitted. Use of calculators on cell phones, IPODS, Blackberries, PDAs or any other type of
communication equipment is not permitted. Attempted use of these types of calculators will result in
immediate termination of the test and a grade of zero. A limited number of calculators will be
available from the test proctor. Students will be required to show, in writing, the steps for solving test
items for both formats of testing. The paper on which the students show the steps in calculating the
answers will be submitted to the test proctor upon completion of the test. Paper and pencil test
answers will be placed on the answer sheet by the student.
Students are to arrive at the testing area at least 5-10 minutes before testing is scheduled to
begin. One hour is allowed to complete the 20-item test. All tests will be turned in at the end of the
hour. Students who arrive after the testing has begun will only have the remaining time to complete
the test. Students are not allowed to leave the testing area until they are finished with the test or
until the hour is over. If a student leaves the testing area prior to finishing the test, that student
forfeits/terminates that testing opportunity and may not reenter the testing area during that hour.
Failure to register for or attend the scheduled testing time will be treated as a failed attempt.
Exceptions to this policy will be at the discretion of the Learning Center Coordinator.
The Academic Conduct policy found in the TCU Student Handbook will be followed at all times
during the testing procedure.
19
Grading ♦
Students will be notified by email of their test results. The Learning Center Coordinator will schedule
a test review time for students who are required to retest.
January 24, 2002
Revised 4/05 mbw/pb; R01/11/07 mbw; Faculty Assembly – approved 09/2008
♦ Does not apply to graduate students. See additional information in the graduate section of this
handbook.
20
Mathematical Rounding Policy for Drug Calculations ♦ (R01/11/07 mbw)
The following guidelines are to be followed when calculating dosage problems.
1. No rounding will be done until the last answer is calculated.
Then the rounding will take place.
2a. When the answer is less than 1, carry the decimal answer to the thousandths place and round to the
hundredths place.
Example:
0.123 = 0.12
OR
0.465 = 0.47
2b. Always place a zero in front of any less than 1 decimal answer to accentuate the decimal.
Example:
.12 should be 0.12
OR
.05 should be 0.05
3. If the answer is greater than 1, carry to the hundredths place and round to the tenths place.
Example:
1.88 = 1.9
OR
2.34 = 2.3
4. All answers must be correctly labeled. This ensures that the student understood that for which they are
solving. Answers should never contain a trailing zero.
Example:
0.5 NOT 0.50
OR
1 mg NOT 1.0 mg
5a. All IV problems having an answer in drops per minute are to be rounded to the nearest whole number.
Example:
41.25 gtts per minute = 41 gtts per minute
30.5 gtts per minute = 31 gtts per minute
5b. Any IV problem solving for mL/hr should be carried to the tenths decimal place.
Example:
41.25 mL/hr = 41.3 mL/hr (not 41 mL/hr)
21
Guidelines for Reporting of Incidents
1. Any incident that creates a potential for injury or harm to any individual (patient, staff, student,
faculty, etc.) must be immediately reported to the assigned faculty member. The faculty member
will also report the incident to the nursing program director.
2. The faculty member may ask the student to assist in preparing an incident report.
Attendance
Students are required and expected to attend all classes and practica. If you are unable to do so
you must notify the teacher prior to class or practicum. Failure to notify the teacher will result in a
zero for the day.
♦ Does not apply to graduate students. See additional information in the graduate section of this handbook.
22
Examinations
Examinations are listed on the tentative class schedule. Students will take each examination at the
time scheduled. In the event of extenuating circumstances, the student must contact the lead
teacher prior to or during the class period the examination is being taken. The student will make up
the examination within 48 hours after returning to class or practicum. Arrangements to make up the
examination will be made through the lead teacher. Make up exams may be of short answer or
essay type. A student who fails to comply with the above will not be permitted to take the
examination, and the grade will be recorded as zero.
Final Examinations
Final examinations will be given on dates and times as specified by the TCU Schedule of Classes or
on modifications made by the nursing program. University policy prohibits changing of exam dates
from the printed schedule unless there are more than two examinations within a 24-hour period.
Individual concerns need to be addressed early in the semester to the lead teacher of an individual
course.
Quizzes/Study Questions/Assignments
Students are responsible for coming to class prepared for the day’s assignment. All assignments
are due on the date specified on the class schedule. If an extension needs to be made for an
assignment due to extenuating circumstances, the lead teacher of the course must be notified in
advance of the due date to make an appropriate decision on the request. Any assignment turned in
late will lose points as noted on the evaluation form of the particular assignment.
Formal Complaints
Nursing defines a formal complaint as any issue presented in writing that invokes the University
Appeals or Grievance Policies and Procedures. Nursing students are advised to follow TCU policies
and procedures when filing a formal complaint.
Classroom/Clinical Participation ♦
Students are expected to participate in class discussion. Each student will be accountable for all
assigned objectives. Some classes may be led by students, in which case, the students may
determine what will be used to generate discussion (e.g., role-play, case study).
1. Nursing students enrolled in clinical nursing courses must attend clinical orientation and testing
2.
3.
4.
5.
6.
sessions that are held the first week of each semester. Absence may cause cancellations of
enrollment in these courses.
The student will be held accountable for all content taught in previous courses.
The student who demonstrates clinically unsafe behavior can be administratively removed from
or will fail the practicum course.
If a student is ill or otherwise cannot attend a practicum, that student is responsible for notifying
the faculty member and the agency. Students are expected to be on time to practicum and to be
prompt for any appointments made.
The American Psychiatric Association (APA) format will be used for all written material in all
classes.
Students are expected to adhere to the Academic Conduct Policy of the University
http://catalog.tcu.edu/undergraduate/ . Students are expected to conform to the standards of
nursing practice as stated in the Texas Board of Nursing’s Nursing Practice Act, Rules and
Regulations, and Disciplinary Sanction Policies.
23
7. At the beginning of each semester, each student must review basic information regarding use of
standard precautions. The student will turn in a signed statement to the effect that the student is
responsible for implementing the practice.
8. Clinical attendance is mandatory. Clinical assignments are often made in advance, and students
are expected to arrive in practicum fully prepared. Unprepared students will be sent home from
clinical and will not earn credit for the day. Clinical preparation may require reading, practicing in
the skills lab, or writing care plans prior to arrival at practicum.
9. As part of the clinical experience students have the opportunity to work in several clinical settings
and with numerous clients during their years as a student in the nursing program. As
professional nursing students, students are expected to keep confidential all information
entrusted to them by clients, peers, faculty, and colleagues in a practicum setting.
♦ Does not apply to graduate students. See additional information in the graduate section of this
handbook.
24
Community Experiences – Personal Safety
1. Car safety—be sure your gas tank is full, windows are raised, doors are locked. Park in front of
the home or agency, not in front of a deserted building. Do not park your car or get out if there
are groups of people congregating in front of the home or agency you were to visit. Do not drive
down blocks where groups of people are congregating in or near the street. Do not drive down
alleys. Do not get out of your automobile if someone is approaching or has just passed—wait
until all persons are 50 yards or more away from the car. Lock your parked car.
2. Personal safety—conduct yourself in a confident manner. Acknowledge residents with a ―hello‖
or ―good morning‖. Leave your purse at home or lock it in your trunk before leaving home. Keep
cell phone, your driver’s license and only a small amount of money on your person. Know where
you are going. Dress conservatively. Have keys ready when walking to your car. In summary—
use common sense!
3. Do not transport clients, families, or others.
4. Do not give money to clients, families, or others.
5. Use elevators versus stairs. Stand by the controls. Don’t get on if it looks suspicious; get off if
you feel uncomfortable.
6. DO NOT give clients your phone number or email address.
Medication Administration ♦
One of the most challenging learning opportunities in the student nursing experience is the
administration of medications. To accomplish this objective the student is prepared by
pharmacology class, drug calculation practice, the study of anatomy and physiology,
pathophysiology, microbiology, and the specific learning of the five rights of patient medication
administration. All of this is done to prepare the student for the next step, that of administering to the
patient/client the correct medication. In the state of Texas a nursing student is prohibited from
administering medication without supervision while functioning as a student nurse. It is the
responsibility of the instructor to be present for every medication given or to ensure appropriate
supervision for the student.
The instructor will communicate the rules for administration of medications in a particular
practicum. It is the responsibility of the student to know and follow these rules. If there is any doubt
about a specific situation, do not administer the medication and notify the instructor immediately.
Professional Attire (effective August 2009) ♦
Students are to be professionally attired at all times when representing themselves as Harris
College-Nursing students. The general requirements for the uniform for students of the nursing
program will be as follows:
In a clinical facility requiring a uniform:
 Dark purple scrubs with an emblem patch* from the nursing program on the left upper sleeve and
white shoes. Lavender or lilac colors are NOT suitable. The uniform may be a purple scrub dress
or scrub top and pants. The scrub top must have a modest neckline. A solid white shirt may be
worn underneath if desired. The top may be tucked in or left untucked from the pants. The scrub
pants must extend to the ankle and may be straight legged or have knit cuff. Hem of scrub pant
must be at least 1‖ from the floor. Scrub pants must be loose fitting enough to allow for
comfortable bending and squatting.
 The shoes must be primarily white, closed toe, closed heel, leather and clean. No clogs. Shoes
must be clean, comfortable and quiet. Socks or hose should be worn. Socks may be white or
purple.
25
In a clinical facility requiring a laboratory coat over street clothes:
 A white lab coat must be worn with the Harris College-Nursing emblem patch sewn to the left
upper sleeve. The lab coat may be fingertip length or knee length.
 Street clothes include skirt or slacks with a shirt or blouse or dresses. Do not wear jeans, shorts,
tee shirts, flip flops, or sandals. Shoes should be clean, comfortable with low heels and closed
toe and heel. Socks or hose should be worn.
♦ Does not apply to graduate students. See additional information in the graduate section of this
handbook.
In any clinical setting:
 Hair must be pulled back, secured and up off the collar.
 Jewelry is kept to a minimum. One ear ring per lobe. Tongue and/or nose jewelry must be
removed during clinical.
 Fingernails should be clean and trimmed no longer than the fingertip. No nail jewelry, artificial
nails, or nail polish are permitted.
 Students must wear a watch that allows them to count seconds.
 Tattoos must be covered.
 Smoking while in uniform is unacceptable.
 Professional behavior is mandatory when TCU uniform is worn in the community.
As the requirements of clinical agencies vary, each clinical instructor will provide specific information
about uniforms to be worn. Any questions about grooming or professional attire should be
addressed to the instructor prior to the clinical experience.
Student shall not wear the student uniform, school patch or school nametag when employed in
any setting.
(Individual faculty or courses may have different requirements or expectations. You will be
notified of these differences at the beginning of the semester.)
*
Emblem patch can be purchased at Dorothy’s Scrubs, Etc.; 1524 Pennsylvania Ave, Fort Worth,
TX 76104; 817-332-7580
26
TCU, HARRIS COLLEGE-NURSING POSITION STATEMENT ON STUDENT TRAVEL WITH
AGENCY PRECEPTORS OR MENTORS
Background: Some TCU – Harris College-Nursing courses place students in agency or community
settings utilizing preceptors or mentors. There are situations when the nature of the student
activities may require student travel to alternate locations.
Position Statement: TCU – Harris College-Nursing prohibits students riding in vehicles driven by
agency preceptors or mentors. TCU – Harris College-Nursing is not able to monitor the safety of
these situations and therefore cannot be responsible for the safety of students riding with agency
preceptors or mentors. TCU – Harris College-Nursing also prohibits students providing rides for
preceptors, mentors, or clients.
STUDENT FEES * ♦
In addition to tuition and University fees nursing students are responsible for the following:
Clinical/lab fee ................................................................................................... $165/ course/ semester
Liability insurance ............................................................................................................. $10/ semester
Standardized exams/Total testing package .................................................................... $120/ semester
Criminal Background Check (Basis: entry or reentry to clinical sequence) ......................... approx.. $50
(Background check fee is paid directly to Group One upon online registration)
Drug Screen (Basis: entry or reentry to clinical sequence) ............................................................... $50
* Subject to change
♦ Does not apply to graduate students. See additional information in the graduate section of this handbook.
27
IMMUNIZATIONS AND DOCUMENTATION REQUIRED PRIOR TO ENROLLMENT IN CLINICAL
COURSES
Copies of documentation of immunization status and Basic CPR certification must be presented
prior to enrollment in clinical nursing courses. Only copies are accepted and should be sent to the
nursing program Student Records Office, TCU Box 298620, Fort Worth, TX 76129. We prefer
mailed copies but you may bring them to the Student Records Office, Annie Richardson Bass
Building, room 233.
If annual renewals are necessary, for example, CPR certification or Mantoux, copies of the renewals
are due before the first day of classes each semester. * Due to the complexity of monitoring the
status of large numbers of students, we can only accept documentation at the beginning of the
semester.
See copy of Immunizations and Documentation Required for All Nursing Students Enrolled in Clinical
Courses.
* These records are required by our contracts with clinical agencies.
28
IMMUNIZATIONS AND DOCUMENTATION REQUIRED FOR ALL NURSING
STUDENTS ENROLLED IN CLINICAL COURSES
IMMUNIZATIONS
REQUIREMENTS
Tetanus/Diphtheria/Pertussis (Tdap)
Booster within 10 years
Measles, Mumps, Rubella (MMR)
Those born since January 1, 1957, must have two (2) doses since 12
months of age. The two (2) doses must be at least 30 days apart.
Hepatitis B
The completed three dose series must be received before contact with
clients in practica.
Varicella (chickenpox)
All practicum students must document evidence of immunity to varicella
(chickenpox). This requirement may be met by either of the following:
1. Documentation of varicella immunization. Immunization for
adolescents and adults is a series of two doses 4 to 8 weeks apart.
2. Positive varicella titer.
Seasonal Flu (TBA each fall semester)
(by Jan. 1 for spring semester)

Must have documentation of annual seasonal flu vaccine which includes
the following information: (a) person receiving vaccine, (b) date of
vaccine administration, (c) vaccine manufacturer and lot number, (d)
name and title of vaccine administrator, (e) address of clinic/office where
vaccine was received.
Each student MUST PROVIDE COPIES of documentation of all the above immunizations PRIOR to initial
enrollment in clinical nursing courses. In addition, students must provide copies of documentation of:
Documentation Needed
CPR healthcare provider certification
REQUIREMENTS
Annual certification of:
American Heart Association: BLS for Healthcare Provider
or
American Red Cross: CPR for the Professional Rescuer
(even though your card may show a 2-year expiration, nursing students
are required to renew annually)
TB Skin Test or chest x-ray
Negative TST (TB skin test) results or
Negative chest x-ray
o
o
o
CPR certification must include a hands on demonstration of skills
CPR and TB skin test must not expire during the semester
*These documents are due August 1 for fall semester and January 1 for spring semester.

Students who are not in compliance with the above policy will be administratively removed from all
practicum courses. Students will not be able to re-enroll in the practicum courses until the above requirements
have been met. Once the above requirements are met, students may re-enroll in open practicum sections. This
may result in a change of practicum sections. Missed practicum time cannot be made-up and will be counted
as unexcused absences handled according to policies stated in each course manual.

All students enrolled in practicum courses must carry health insurance. Proof of health insurance for full time
students (9 credit hours or more during fall or spring semesters) is monitored by the TCU Health Center.
Students who are enrolled in fewer than 9 credit hours during fall or spring semesters must submit proof of health
insurance to the Nursing office (Bass 233) prior to the beginning of each semester. All students enrolled in
summer practicum courses must submit proof of health insurance prior to the beginning of the summer
term.
FOR MORE INFORMATION ON IMMUNIZATIONS, CONTACT YOUR HEALTHCARE PROVIDER, PUBLIC HEALTH
CLINIC OR TCU STUDENT HEALTH CENTER AT (817) 257-7940 OR (817) 257-7938.
29
REQUIRED HEALTH INSURANCE ♦
All undergraduate students carrying nine or more semester hours MUST have health and accident
insurance coverage. That coverage can be offered either through the plan offered by the University
or through your family’s plan.
Harris College-Nursing majors enrolled in practicum nursing courses on a full or part-time basis,
must provide proof of health insurance either offered by the University or through your family’s plan.
This varies from the TCU policy that does not require insurance for student enrolled in less than 9
semester hours.
All students enrolled in practicum courses must carry health insurance. Proof of health
insurance for full time students (9 credit hours or more during fall or spring semesters) is
monitored by the TCU Health Center. Students who are enrolled in less than 9 credit hours
during fall or spring semesters must submit proof of health insurance to the Harris CollegeNursing office (Bass 233) prior to the beginning of each semester. All students enrolled in
summer practicum courses must submit proof of health insurance prior to the beginning of
the summer term.
♦ Does not apply to graduate students. See additional information in the graduate section of this
handbook.
30
TCU, HARRIS COLLEGE-NURSING
STUDENT POLICIES: HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA)
Policies: Access, Use, and Protection of Health Information
obtained during the course of Clinical Education
1. All students must sign a Harris College-Nursing Confidentiality Statement prior to accessing patient files in
any agency used for clinical education.
2. All student documents related to patient assignments (journals, care plans, papers, assignment sheets,
etc) must be protected to assure privacy of the patient(s) information by de-identifying the health
information. Your course faculty will tell you the de-identification method to be used.
3. Students should maintain the de-identification of health information when communicating with faculty, one
another, or any other entity through any means including electronic means.
4. Any documents submitted to faculty should contain no protected health information (PHI) or the
information should be de-identified. For example: course papers, care plans, interview information, etc.
5. If protected health information is re-identified for any reason, it is deemed to be protected health
information and is subject to the applicable privacy protections. The student is responsible for maintaining
the security of the re-identified information.
6. Per the TCU-Clinical Agency Identity Verification Policy, only students wearing the approved TCU
identification badge will be granted access to patient information by the clinical agency.
7. Student IDs are to be worn in a visible location on the uniform, street clothing, or scrubs when
representing self as a TCU student nurse. The ID is not to be worn at any other time, such as during a
work shift in a hospital setting.
8. There should be no disclosure of PHI of patients by Harris College-Nursing students. A student should
consult the course faculty if a student has a question about PHI related to disclosures required by law,
disclosures for public health activities, disclosures about victims of abuse, neglect or domestic violence;
law enforcement purposes, disclosures about decedents, disclosures for cadaver organ, eye, tissue
donation, disclosures to avert a serious threat to health or safety, disclosures for specialized government
functions, disclosures for workers' compensation.
9. If documents containing PHI are in use by students (for example, in the hospital unit, Harris CollegeNursing computer lab, etc.) the document(s) must be shielded so others may not see the information. If
the person using the documents leaves the room, the documents must not be left on top of the desk for
others to see. Locking the documents in a secure file is recommended.
10. If faxing, copying or printing documents containing PHI it is the user's responsibility to assure protection of
the PHI.
11. Documents containing PHI should only be shredded by the person authorized to have the PHI.
31
Policy: HIPAA Regulations and Harris College-Nursing Research and/or Professional Projects
1. Any student research or professional projects should maintain the protection of health information
collected during the duration of the project by including no identifying patient information on project
instruments. If a code is used to re-identify the participant information, the codebook must be maintained
in a locked, secured file. If an informed consent document is signed, the documents should be maintained
in a locked, secured file apart from any patient/subject information. Informed consent documents should
be submitted to the Harris College-Nursing Administrative Office at the end of the project. The documents
will be stored according to TCU Safeguards in Human Research guidelines.
2. In the event protected health information collected during a research project was disclosed, the student
and the student’s committee chairperson should report the disclosure to the Harris College-Nursing
Privacy Official. The Privacy Official will determine if a disclosure of PHI was made for 50 or more
individuals involved in a research project. If so, an accounting of the disclosure should include the
following: a) name of research activity b) a description of the project in plain language including the
purpose for the research and selection of criteria for the records c) a description of the type of PHI
disclosed d) the date or period of time of the disclosure e) name, address and phone number of the
sponsor of the research f) the name of the researcher to whom the PHI was disclosed g) a statement that
the PHI of the individual may or may not have been disclosed during the research activity.
If there were fewer than 50 individuals involved in the research, the Privacy Official must provide an
accounting for every disclosure of PHI for each individual whose PHI was disclosed.
In addition, if an individual involved in a research study of 50 or more individuals requests an accounting
for the disclosure of PHI pertaining to the individual, the Privacy Official must make a reasonable attempt
to satisfy this request.
HIPAA Privacy Official
1. The Director of the nursing program is the Privacy Official, but may delegate his or her duties to others if
so desired. The appointment is continuous and will transfer when and if a new Director is named.
2. The duties of the Privacy official include: a) Maintaining program compliance with HIPAA regulations b)
developing Harris College-Nursing policies and procedures related to HIPAA regulations c) maintaining
documentation of complaints and sanctions d) overseeing HIPAA training program.
3. The chain of command under the Director of the nursing program, as the Privacy Official is student to
faculty, faculty to lead teacher of course (if applicable), and faculty/lead teacher to Director. At times it may
be appropriate for the student and faculty/lead teacher to meet simultaneously with the Director.
32
Policy: Required Training Regarding HIPAA
Regulations and Policies for All Harris College-Nursing Students
1. All Harris College-Nursing students enrolled in practicum courses for the first time will complete a training
program regarding HIPAA regulations and policies during the first week of the academic semester. Each
will be asked to sign a form indicating understanding of the Harris College-Nursing policies and
procedures related to HIPAA and the Harris College-Nursing Confidentiality Statement.
2. If a breach in confidentiality occurs, the student will complete a retraining program as soon as possible
following the incident.
3. All students will complete retraining within one month following a significant change in privacy practices.
Policy: Sanctions for Violating Harris CollegeNursing Policies and Procedures related to HIPAA
1. A complaint regarding a breach in patient privacy may be brought to the Privacy Official with the
assurance that no retaliatory measures will be taken against the person bringing the complaint.
2. The Privacy Official will document the complaints received and their disposition and maintain the
document in a locked, secured file.
3. Students who violate the protection of health information are subject to sanctions, which may include, but
are not limited to: unit or course grade reduction; failure of course; suspension from program.
Effective Fall 2003, Policy in Student Handbook
33
TCU, HARRIS COLLEGE-NURSING
Student Completion of Training Regarding Harris College-Nursing
Policies and Procedures Regarding HIPAA
I have completed the required reading of the Harris College-Nursing policies and procedures regarding
HIPAA. I understand that if I have questions I should ask my course faculty for clarification or information.
Student signature
Date
Effective fall 2003
Clinical Course Faculty will initiate and collect student completed forms during course orientation.
The completed form is to be placed in student’s file in Harris College-Nursing’s administrative office.
34
TCU, HARRIS COLLEGE-NURSING
STUDENT CONFIDENTIALITY AGREEMENT
Patient confidentiality at the facilities used by TCU, Harris College-Nursing is of primary importance. In
addition to each facility policy, a federal law called the Health Insurance Portability and Accountability Act
(HIPAA) requires patient health information to be kept confidential. Additionally, patients and their families
have a right to deal with their issues in a private and secure manner, trusting that their privacy will be
maintained. In order to protect this right to confidentiality and to comply with federal and state laws, students
must agree to hold all information (including, but not limited to, patient names, their health information, and
relevant agency information) gained through their clinical assignments or professional/research projects at
any facility used by TCU, Harris College-Nursing in strictest confidence. Confidentiality includes, but is not
limited to, not discussing patients or their health conditions with persons who do not have a need to know and
not removing any documents with individually identifiable patient data from the facility.
I also understand the terms of this Student Confidentiality Agreement, and I agree to abide by the above
confidentiality requirements. I further understand that any breach of a patient’s confidentiality may result in
disciplinary action against me as described in the Harris College-Nursing student handbook.
Printed student name
Printed faculty name
Student signature
Faculty signature
Date
Date
Effective September 2003
To be initiated by course faculty during course orientation
To be filed in student’s file in Harris College-Nursing’s administrative office
35
STUDENT ID CARD ♦
This ID is to be worn in a visible location on the uniform, street clothing, or scrubs when representing
yourself as a TCU student nurse. The ID is not to be worn at any other time, such as during a work
shift in a hospital setting.
STUDENT NURSES’ ASSOCIATION ♦
This organizational branch of the Texas Nursing Students’ Association and the National Student
Nurses’ Association provides students opportunities to participate in local, state, and national affairs.
Membership in the Harris College-Nursing chapter is voluntary. These organizations are concerned
with the role of the nursing student, the role of the nurse in the community, and the future of nursing.
Meetings are held monthly and regional meetings can be attended each semester. Participation is
strongly encouraged.
RESOURCES ♦
Employment
Students may be employed on or off campus as opportunities are available and the course load and
schedule permits. Work schedules should allow sufficient time for study. Students employed in
clinical agencies may not wear the school uniform or name tag during such employment. The
uniform worn during such employment should be the one required by the employing agency.
Students who are employed in a clinical setting must not sign their names as nursing students.
Learning Center
A Learning Center in the nursing building is available to all nursing students to enhance independent
learning and provide access to computers, audiovisual materials, and a practice lab for clinical skills.
In the Learning Center the student may become an active participant in an environment that
facilitates both individual and small group learning situations. In addition to this facility and other
University resources, nursing students have access to other libraries located in metroplex
universities and various clinical facilities.
No food or drink is allowed.
Testing Program
All nursing students enrolled in sophomore II and higher nursing courses will participate in nationally
standardized testing for nursing.
Students are required throughout the program to take the achievement tests as listed.
Purpose of Testing
 Assists in documenting student outcomes
 Identifies strengths and weaknesses of students and aggregate groups of students
 Provides curriculum evaluation data
 Strengthens the NCLEX outcomes
36
Procedure – Completion of all tests is a program requirement. Those students who do not complete
tests by the indicated deadline may be administratively removed from nursing courses.
Tests
 Admission Assessment (A2): All declared nursing students will complete test prior to the first
clinical semester in the nursing major. The tests will be administered in the Learning Center.
The A2 assesses essential math skills, reading comprehension, vocabulary and grammar, critical
thinking skills, anatomy/physiology, levels of stress and preferred learning style. The students
may take the A2 once in a 12 month period.
 Mid-curricular exam: This exam will be taken at the end of Junior I. Tests of this type serve as
quality benchmarks for our program, and document the achievement levels of students. Students
should use this testing experience as an opportunity to determine their knowledge base
compared to other students in nursing programs throughout the nation. The test results provide
students with information about content areas in which they may have deficiencies. The MidCurricular exam compares our students’ performance to the performance of students in other
baccalaureate nursing programs across the country. The exam in not timed, and usually takes
about 90-120 minutes to complete. Failure to complete this exam at the assigned time will
result in being administratively withdrawn from all nursing courses until the exam is
completed.
 HESI Exit Exam (E2) will be taken at the end of the Senior I semester. The HESI Exit Exam, a
nationally standardized exam, is used to identify strengths and weaknesses of students and a
possible need for remediation prior to taking NCLEX-RN. This comprehensive examination
consists of 160 questions, and serves to evaluate the student’s knowledge base of core concepts
covered on NCLEX. The question format and exam blueprint match those in the latest NCLEX
test plan. Students will take this test outside of class time.
If the student scores below a score of 850, the student will be required to retake the HESI Exit
Exam within the first two weeks of the Senior II semester (there will be an additional one-time test
fee for this exam). If the student fails to score 850 on the retest, the student will be required to
enroll in an 8 week online NCLEX review course in addition to their normal course work.
R08-2007
♦ Does not apply to graduate students. See additional information in the graduate section of this
handbook.
37
Sigma Theta Tau International
Since 1970, the Beta Alpha Chapter of the International Honor Society for Nursing, Sigma Theta
Tau, has selected members from the Harris College-Nursing student body on the basis of academic
merit.
HONORS PROGRAM ♦
Nursing majors who plan to pursue Departmental Honors must be members of the Honors Program
and should contact the Harris College-Nursing office as soon as possible for assignment to an
Honors advisor. Students wanting to pursue University Honors should contact the TCU Honors
Program office early in their freshman year.
♦ Does not apply to graduate students. See additional information in the graduate section of this
handbook.
38
PROFESSIONAL BEHAVIOR
The Harris College-Nursing major is expected to display professional behaviors that are conducive to
the practice of professional nursing at all times. Professionalism is a concept that embraces
conduct, attitudes, values, and standards relating to the practice of a professional. Professionalism
in nursing can be witnessed in individual and collaborative practice and organizational participation.
The nursing students are expected to incorporate into their behavior the TCU Student Code of
Conduct and the policies and regulations as established by the following regulatory bodies:
1.
2.
3.
4.
American Nurses’ Association (ANA) Code of Ethics for Nurses
Nurse Practice Act—Texas Statutes Regulating the Practice of Nursing (www.bon.state.tx.us)
American Hospital Association Bill of Rights
National Student Nurses’ Association, Inc.—The Student Bill of Rights and Responsibilities
Professional Conduct Statement
The faculty of Harris College-Nursing expect professional nursing students to conform to the
standards of nursing practice as stated in the Texas Statutes Regulating the Practice of Professional
Nursing (may be downloaded/printed from the following site: http://www.bon.state.tx.us/nparr.htm).
The term unprofessional conduct is described as any act, practice or omission that fails to conform to
the accepted standards of the nursing profession. Unprofessional conduct includes but is not limited
to the following:
1. Failing to assess and evaluate a patient's/client's status or failing to institute nursing intervention
which might be required to stabilize a patient's/client's condition or prevent complications.
2. Knowingly or consistently failing to accurately or intelligibly report or document a patient's/client's
symptoms, responses, progress, medications, and/or treatments.
3. Knowingly or consistently failing to make entries, destroying entries, and/or making false entries
in records pertaining to the giving of narcotics, drugs, or nursing care.
4. Appropriating medications, supplies, equipment, or personal items of the patient/client or
employer.
5. Failing to administer medications and/or treatments in a responsible manner.
6. Performing or attempting to perform nursing techniques and/or procedures in which the nursing
student is unprepared, unsafe, and/or without appropriate supervision.
7. Violating the confidentiality of information or knowledge concerning the patient/client except
where required by law.
8. To cause, suffer, permit, or allow physical or emotional injury to the patient/client or failing to
report same in accordance with the incident reporting procedure in effect where the nurse is
employed or working.
9. Leaving a nursing assignment without notifying appropriate personnel.
10. Failing to report to the Board or the appropriate authority in the organization in which the nurse is
working, within a reasonable time of the occurrence, any violation or attempted violation of the
Texas Nurse Practice Act or duly promulgated rules, regulations, or orders.
11. Expressly delegating nursing care functions or responsibilities to a person who lacks the ability or
knowledge to perform the function or responsibility in question.
Failure to meet these standards will result in a failing grade for the clinical course.
39
Unsafe Nursing Practice
Definition: Unsafe nursing practice is defined to include, but is not limited to, the following behaviors
of a nursing student:
 Allowing own value system to interfere with client care/well being.
 Demonstrating lack of acceptable or safe nursing judgment in performing nursing interventions.
 Engaging in activities for which the nursing student is not academically prepared or which exceed
the nursing student's own limitations.
 Engaging in activities that do not fall within the realm of standardized nursing practice and
endangers patients.
 Recording and/or reporting client-care data and/or nursing interventions inaccurately or
fraudulently, or failing to record and/or report data.
 Appropriating medications, supplies, equipment, or personal items of the patient/client or
employer.
 Endangering the welfare of the client. Examples of behaviors:
(1) Reporting to practicum under the influence of alcohol.
(2) Reporting to practicum under the influence of drugs or other substances that hamper proper
functioning in their responsibilities.
(3) Reporting to practicum when physically or mentally unsafe to assume care whether due to
sleep deprivation, infectious disease, extreme stress, or any other condition.
(4) Failing to administer medications and/or treatments in a responsible manner, which includes
having adequate knowledge of the drug.
(5) Violating the confidentiality of information or knowledge concerning the patient/client except
where required by law.
(6) Leaving a nursing assignment without notifying appropriate personnel.
(7) Failing to provide a safe environment.
 Failing to comply with institutional policies and procedures in implementing nursing care.
Code of Ethics for Nurses
1. The nurse, in all professional relationships, practices with compassion and respect for the
inherent dignity, worth, and uniqueness of every individual, uniqueness of every individual,
unrestricted by considerations of social or economic status, personal attributes, or the nature of
health problems.
2. The nurse’s primary commitment is to the patient, whether an individual, family, group, or
community.
3. The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the
patient.
4. The nurse is responsible and accountable for individual nursing practice and determines the
appropriate delegation of tasks consistent with the nurse’s obligation to provide optimum patient
care.
5. The nurse owes the same duties to self as to others, including the responsibility to preserve
integrity and safety, to maintain competence, and to continue personal and professional growth.
6. The nurse participates in establishing, maintaining, and improving health care environments and
conditions of employment conducive to the provision of quality health care and consistent with
the values of the profession through individual and collective action.
7. The nurse participates in the advancement of the profession through contributions to practice,
education, administration, and knowledge development.
8. The nurse collaborates with other health professionals and the public in promoting community,
national, and international efforts to meet health needs.
40
9. The profession of nursing, as represented by associations and their members, is responsible for
articulating nursing values, for maintaining the integrity of the profession and its practice, and for
shaping social policy.
 American Nurses Association
41
BLOODBORNE PATHOGENS EXPOSURE
Prevention
1. Any exposure to bloodborne pathogens during practicum should be reported immediately to the
faculty and the person in charge on the unit, and the individual(s) must follow that institution’s
policy regarding bloodborne pathogen exposure.
2. If post-exposure procedures are not available to the involved individual, the student/faculty
should go immediately to Harris Methodist Fort Worth Employee Health Department. Employee
Health procedures will be available through Harris Emergency Department if it is after hours.
3. Student must immediately notify the faculty of any exposure no matter how small it might be.
4. Incident reports are to be completed by the faculty member and student(s) involved at the facility
and at TCU Harris College-Nursing (copy forwarded to TCU Health Center).
5. TCU policy is located in Director’s office.
42
TCU, HARRIS COLLEGE-NURSING
Use of Standard Precautions
All undergraduate and graduate students will complete verification of Standard Precautions competencies, as
required by clinical agencies. In addition, students must acknowledge their awareness of and willingness to
utilize Standard Precautions in all TCU related activities.
I,
have received instruction regarding
(print full name)
―Standard Precautions‖ and am familiar with these requirements.
I have had an opportunity to have my questions answered about the use of standard precautions in health
care settings.
I agree to consistently implement these precautions.
Student’s signature
Date
Reference:
http://www.saf.tcu.edu/tcu%20web/Written%20Exposure%20Control%20Plan.pdf
02/06
43
ADVISING ♦
What a Student Can Expect From an Adviser
1.
2.
3.
4.
Concern for the student's welfare as an individual person.
Information concerning academic programs, requirements, policies, and procedures.
Assistance in exploring and clarifying life goals and career alternatives.
Assistance in exploring educational options and planning a coherent academic program, including
choosing a major.
5. Assistance in selecting and scheduling of courses.
6. Assistance with various academic forms, including schedule changes, Academic Advisement Special
Permission form, etc.
7. Assistance in reviewing the student's academic program each regular semester, matching the
academic record with the applicable degree requirements.
8. Special assistance, including strategies for improving study skills, if the student experiences
scholastic difficulties and is placed on academic probation.
9. Referral to the Harris College-Nursing – Nursing Academic Enhancement Program (ACE Program) to
assist with financial, academic, test-taking skills, math difficulties, writing issues, career services,
English as a second language, and personal or pastoral counseling when appropriate, to enhance
academic, or personal performance in order to achieve success.
10. Confidentiality concerning all personal and private matters, in accordance with the provisions of the
Family Educational Rights and Privacy Act of 1974 (The Buckley Amendment).
The student's advising file is considered part of his or her academic records protected by the Family
Educational Rights and Privacy Act of 1974 (the Buckley Amendment). TCU's policy regarding this act is in
the Undergraduate Studies Bulletin. This act does exclude a student's right of access to personal notes that
the adviser may have made during the advising sessions.
♦ Does not apply to graduate students. See additional information in the graduate section of this handbook.
44
What an Adviser Can Expect From the Student
1. Giving thoughtful consideration to personal, educational, and career goals.
2. Becoming knowledgeable about his or her academic program, including all applicable requirements
and policies, and monitoring his or her own progress.
3. Accepting responsibility for choices and decisions and asking questions when information is
needed.
4. Keeping advising appointments or calling to reschedule well in advance.
5. Seeking assistance as needed and providing timely notice and information concerning any
academic problems.
6. Notify instructor if having academic or personal problems in which the ACE Program will be
beneficial.
7. Taking responsibility, accountability and follow thru with the recommendations made by the ACE
Program. Keep advisor informed of progress in the ACE Program.
8. Giving advance consideration to a tentative schedule of classes each semester prior to the
advising conference, and . . .
ARRIVING PREPARED BY
Bringing all forms, class schedule
book, pen, paper, etc. to the appointment
45
TCU, HARRIS COLLEGE-NURSING
BSN Degree Requirements ♦
Nursing Prerequisites
THE FOLLOWING COURSES MUST BE COMPLETED WITH A GRADE OF ―C‖
OR HIGHER.
Anatomy & Physiology I (BIOL 20204/ Lab) (4 SH) (NSC)
Anatomy & Physiology II (BIOL 20214/ Lab) (4 SH) (NSC)
Microbiology (BIOL 20233/ Lab) (3 SH) (NSC)
Lifespan Growth and Development (NURS 10303) (3 SH) (SSC)
Introductory Psychology (PSYC 10213) (3 SH)
Introductory Sociology (SOCI 20213) (3 SH) (CA, SSC)
Math – Elementary Statistics (MATH 10043) (3 SH) (MTH)
Nutrition (NTDT 20403) (3 SH)
Please see TCU - Core Curriculum Diagram grid for University Requirements.
(See next page).
Registered Nurses interested in the ADN-MSN program should contact Dr. Kathleen Baldwin at
(817) 257-6748 or k.baldwin@tcu.edu to schedule an appointment or to request information.
♦ Does not apply to graduate students. See additional information in the graduate section of this handbook.
46
47
TCU – HARRIS COLLEGE-OF NURSING & HEALTH SCIENCES
Bachelor of Science Degree in Nursing (BSN)
Suggested Plan of Study
Freshmen beginning Fall 2009
Freshman Semester I
Freshman Semester II
BIOL 20204 (Anat & Phys) (NSC) .............................. 4
ENGL 10803 (Freshman Comp) (WCO) ..................... 3
PSYC 10213 (General Psychology) ............................ 3
NURS 10043 (Survey of Prof Nsg) (CA) ..................... 3
Humanities elective (HUM) .......................................... 3
BIOL 20214 * (Anat & Phys) (NSC) ...................... 4
NTDT 20403 (Nutrition) ........................................ 3
Religious Traditions (RT) ...................................... 3
SOCI 20213 (Introductory Sociology) (SSC,
CA) ..................................................................... 3
NURS 10303 (Human Development) (SSC) ........ 3
Total credit hrs ......................................................... 16
Total credit hrs .................................................. 16
Sophomore Semester I
Sophomore Semester II
BIOL 20233 * (Microbiology) (NSC) ............................ 3
ENGL 20803 (Sophomore Comp) (WCO) ................... 3
Historical Traditions (HT) ............................................. 3
MATH 10043 ** (Elem Statistics) (MTH) ..................... 3
NURS 20033 (Teaching Strategies) (OCO) ................ 3
Humanities Elective (HUM).......................................... 3
NURS 20041 (Genetics/ Genomes in Nursing)…..1
NURS 20163 (Pharmacotherapeutics) ................. 3
NURS 20224 (Fund/Assess: Concepts) ............... 4
NURS 20284 (Fund/Assess: Practicum) .............. 4
Free Elective ......................................................... 3
Elective # .............................................................. 2
Total credit hrs ......................................................... 18
Total credit hrs .................................................. 17
Junior Semester I
Junior Semester II
NURS 30714 (Adult Nsg I: Concepts) ......................... 4
NURS 30783 (Adult Nsg I: Practicum) ........................ 3
NURS 30813 (Psyc-MH Nsg: Concepts) ..................... 3
NURS 30882 (Psyc-MH Nsg: Practicum) .................... 2
Humanities elective (HUM) .......................................... 3
NURS 30313 (Mat/Wom Hlth Nsg: Conc) ............ 3
NURS 30382 (Mat Nsg: Practicum) ..................... 2
NURS 30413 (Pediatric Nsg: Concepts) .............. 3
NURS 30482 (Pedi.Nsg: Practicum) .................... 2
NURS 30632 (Gero Nsg)...................................... 2
Fine Arts elective (FAR) ....................................... 3
Total credit hrs ......................................................... 15
Total credit hrs .................................................. 15
Senior Semester I
Senior Semester II
NURS 40053 ## (Crit Inq in Hlth Care Del) (SSC,
GA).......................................................................... 3
NURS 40114 (Adult Nsg II: Concepts) ........................ 4
NURS 40183 (Adult Nsg II: Practicum) ...................... 3
NURS 40632 (Res & Theory in Nsg Prac) .................. 2
Literary Traditions (LT) ................................................ 3
NURS 40813 ## (Com Hlth Nsg: Concepts)
(CSV) ............................................................... 3
NURS 40882 (Com Hlth Nsg: Practicum) ............ 2
NURS 40913 (Role Dev & Nsg Mgmt: Conc) ....... 3
NURS 40984 (Role Dev & Nsg Mgmt: Pract) ....... 4
Total credit hrs .................................................. 12
Total credit hrs ......................................................... 15
*
The following courses will satisfy the TCU CC requirement for Natural Sciences (NSC) Human Experiences and
Endeavors: BIOL 20214 and 20233; applies to NURS-BSN only
** MATH 10023 is a prerequisite to MATH 10043 if lacking two years high school algebra
# Choice of elective will depend on other choices made in the HMVV and HEE
## Writing Emphasis Course (WEM)
Total Graduation Requirements – 124 semester hours; 69 Nursing, 55 Non-Nursing
m allender/ eo Rev. 6-3-09
48
TEXAS CHRISTIAN UNIVERSITY - HARRIS COLLEGE OF NURSING & HEALTH SCIENCES
Bachelor of Science Degree in Nursing (BSN)
Suggested Plan of Study for Army ROTC
Freshmen Semester I
Freshmen Semester II
Summer I
ENGL 10803 Freshmen Composition
NTDT 20403 Nutrition
Historical Traditions/Humanities
BIOL 20204 Human Anatomy & Physiology
PSYC 10213 Introductory Psychology
BIOL 20214 Human Anatomy & Physiology
SOCI 20213 Introductory Sociology
Fine Arts
Literary traditions/Humanities
NURS 10043 Survey of Professional Nursing
NURS 10303 Human Development
MISC 10041 Intro to Leadership I
MISC 10081 Intro to Leadership II
MISC 10001 Leadership Lab
MISC 10001 Leadership Lab
Total Hours = 15
Total Hours = 15
Sophomore Semester I
ENGL 20803 Sophomore Composition
BIOL 20233 Microbiology
MATH 10043 Elem. Statistics *
Sophomore Semester II
NURS 20041 Genetics/ Genomes in Nursing
NURS 20224 Fundamentals & Assessment: Concepts
NURS 20284 Fundamentals & Assessment: Practicum
NURS 20033 Teaching Strategies
HIST 20763 US Military History
NURS 20163 Pharmacology
Religious Traditions/ Humanities
MISC 20042 Basic Leadership I
MISC 10001 Leadership Lab
Total Hours = 18
MISC 20092 Basic Leadership II
MISC 10001 Leadership Lab
Junior Semester I
Summer II
Total Hours = 18
Junior Semester II
Summer III
NURS 30714 Adult Nursing I: Concepts
NURS 30783 Adult Nursing I: Practicum
NURS 30313(Mat/Wom Hlth Nsg: Con
NURS 30382 Maternity Nursing: Practicum-
NURS 30813 Psychiatric-MH Nsg: Concepts
NURS 30882 Psychiatric-MH Nsg: Practicum
NURS 30413 Pediatric Nursing: Concepts
NURS 30482 Pediatric Nursing: Practicum
MISC 30053 Intermediate. Leadership I
MISC 10001 Leadership Lab
NURS 30632 Gerontological Nursing
MISC 30063 Intermediate Leadership II
MISC 10001 Leadership Lab
Total Hours = 16
Senior Semester I
Total Hours = 9
Total Hours = 16
Senior Semester II
NURS 40053 Crit Inq Hth Care Del
NURS 40632 Res & Theory in Nursing
NURS 40813 Community Health Nursing: Concepts
NURS 40882 Com Health Nursing: Practicum
NURS 40114 Adult Nursing II: Concepts
NURS 40183 Adult Nursing II: Practicum
NURS 40913 Role Dev & Nsg Mgt: Concepts
NURS 40984 Role Dev & Nsg Mgt: Practicum
MISC 40053 Adv Leadership I
MISC 10001 Leadership Lab
MISC 40063 Adv Leadership II
MISC 10001 Leadership Lab
Total Hours = 16
Total Hours = 16
* MATH 10023 is a prerequisite to MATH 10043 if lacking 2 years high school Algebra.
Total Graduation Requirements - 139 Semester Hours; 69 Nursing, 44 Non-Nursing, 26 MISC
NALC (National Advanced
Leadership Camp)
NSTP (Nurse Summer Training
Program)
49
TEXAS CHRISTIAN UNIVERSITY
HARRIS COLLEGE OF NURSING & HEALTH SCIENCES
NURSING
Bachelor of Science Degree in Nursing (BSN)
Suggested Plan of Study for Air Force ROTC
Freshmen Semester I
Freshmen Semester II
Summer I
ENGL 10803 (Freshmen Composition)
BIOL 20204 (Hum Anat & Phy)
NTDT 20403 (Nutrition)
BIOL 20214 (Hum Anat & Phys)
Historical Traditions/HUM
Fine Arts Elective
PSYC 10213 (Introductory Psychology)
NURS 10043 (Survey of Prof Nurs)
SOCI 20213 (Introductory Sociology)
NURS 10303 (Human Development)
Literary Traditions
AEST 10001 (Leadership Lab)
AEST 10001 (Leadership Lab)
AEST 10211 (Air Force Today I)
AEST 10221 (Air Force Today II)
Total Hours = 15
Sophomore Semester I
Total Hours = 15
Total Hours =9
Sophomore Semester II
ENGL 20803 (Sophomore Composition)
BIOL 20233 (Microbiology)
NURS 20041 (Genetics/ Genomes in Nursing)
NURS 20224 (Fund/Assess: Concepts)
MATH 10043 (Elem. Statistics) *
NURS 20033 (Teaching Strategies)
NURS 20284 (F/A: Practicum)
NURS 20163 (Pharmacology)
AEST 10001 (Leadership Lab)
AEST 20211 (Devlp of Air Power I)
Religious Traditions/HUM
AEST 10001 (Leadership Lab)
Summer II
Field Training
AEST 20221 (Devlp of Air Power II)
Total Hours = 14
Total Hours = 17
Junior Semester I
Junior Semester II
NURS 30714 (Adult Nsg I: Concepts)
NURS 30313 (Mat/Wom Hlth Nsg: Con)
NURS 30783 (Adult Nsg I: Practicum)
NURS 30813 (Psyc-MH Nsg: Concepts)
NURS 30382 (Mat Nsg: Practicum)
NURS 30413 (Pediatric Nsg: Conc)
NURS 30882 (Psyc-MH Nsg: Practicum)
AEST 10001 (Leadership Lab)
NURS 30482 (Ped. Nsg: Practicum)
NURS 30632 (Gero Nsg)
AEST 30113 (Mgmt/Contemp Aplc)
AEST 10001 (Leadership Lab)
AEST 30123 (Mgmt Conc/ Leaders)
Total Hours = 16
Total Hours = 16
Senior Semester I
Senior Semester II
NURS 40053 (Crit Inq Hth Care Del) **
NURS 40813 (Com Hlth Nsg: Conc) **
NURS 40632 (Res & Theory in Nsg)
NURS 40114 (Adult Nsg II: Conc)
NURS 40882 (Com Hlth Nsg: Pract)
NURS 40913 (Role Dev & Nsg Mgt: Con)
NURS 40183 (Adult Nsg II: Practicum)
AEST 10001 (Leadership Lab)
NURS 40984 (Role Dev & Nsg Mgt: Pract)
AEST 10001 (Leadership Lab)
AEST 40113 (National Security)
AEST 40123 (American Defense Policy)
Total Hours = 16
Total Hours = 16
* MATH 11023 is a prerequisite to MATH 10043 if lacking 2 years high school Algebra.
** Writing Emphasis Course
Total Graduation Requirements - 134 Semester Hours; 69 Nursing, 41 Non-Nursing, 24 AEST
Summer III
50
TCU - HARRIS COLLEGE OF NURSING AND HEALTH SCIENCES
BSN Suggested Plan of Study for Honors Students
Kathryne McDorman Honors Scholar (Lower Division Honors) (15 credit hrs)
McDorman Scholars will have completed fifteen (15) hours of lower division Honors courses, including six (6) hours of
Cultural Visions courses and at least nine (9) hours of Honors courses/electives.
Paul and Judy Andrews Honors Scholar (Upper Division Honors)
Nursing students who complete a research or creative project and present their project during Honors Week will be
recognized as an Andrews Honors Scholar in Nursing. Andrews Honors will be fulfilled with the satisfactory completion
of the Research and Theory Junior Honors Seminar and the Senior Honors Project.
Any university core or nsg prerequisite course offered with Honors designation may be taken to fulfill general honors
designated coursework
Freshman I
ENGL 10803 (Freshman Comp)........................... 3
BIOL 20204 (Human A & P) ................................. 4
PSYC 10213 ........................................................ 3
NURS 10043 (Survey of Prof Nsg) (Honors
designation)…………………………………………..3
Honors course/elective…………………………….. 3
16
Sophomore I
ENGL 20803 (Sophomore Comp) ........................ 3
BIOL 20233 (Microbiology) ................................... 3
MATH 10043 (Elem Statistics) ............................. 3
NURS 20033 (Teaching Strategies) ..................... 3
Honors Cultural Visions course………..…………..3
NURS 20041 (Genetics/ Genomes in Nursing)… 1
16
Junior I
NURS 30714 (Adult Nsg I: Conc) ......................... 4
NURS 30783 (Adult Nsg I: Pract) ......................... 3
NURS 30813 (Psych-Mental Hlth: Conc).............. 3
NURS 30882 (Psych-Mental Hlth: Pract).............. 2
Elective………………………………………………..3
Elective………………………………………………. 2
17
Senior I
NURS 40053* (Critical Inquiry) ............................. 3
NURS 40114 (Adult II: Conc) ............................... 4
NURS 40183 (Adult II: Pract) ............................... 3
NURS XXXX (Senior Honors Project) .................. 3
Elective………………………………………………. 3
16
Freshman II
NTDT 20403 (Nutrition) ........................................ 3
BIOL 20214 (Human A & P) ................................. 4
SOCI 20213 ......................................................... 3
NURS 10303 (Growth & Development) ................ 3
Honors Cultural Visions course……………………. 3
16
Sophomore II
NURS 20224 (Fund / Assess: Conc) .................... 4
NURS 20284 (Fund / Assess: Pract) .................... 4
NURS 20163 (Pharmacology) ............................ ..3
Honors course/elective………………………………3
Humanities Elective………………………………….3_
17
Junior II
NURS 30313 (Mat Nsg: Conc) ............................. 3
NURS 30382 (Mat Nsg: Practicum) ...................... 2
NURS 30413 (Pediatric Nsg: Concepts) ............... 3
NURS 30482 (Pediatric Nsg: Practicum) .............. 2
NURS 30632 (Gero Nsg) ..................................... 2
NURS 40632
(Res & Theory Junior Honors Seminar)…… 2
14
Senior II
NURS 40813 (CH Nsg: Conc) .............................. 3
NURS 40882 (CH Nsg: Pract) .............................. 2
NURS 40913 (RD & Nsg. Mgmt: Conc) ................ 3
NURS 40984 (RD & Nsg. Mgmt: Pract) ................ 4
NURS XXXX (Senior Honors Project (con’t.)…….__
12
All Nursing Honors students should attend Honors advising in addition to Nursing advising
This plan of study is intended to be flexible and less prescriptive.
The following core classes must fit into this plan of study. Most Honors coursework will fulfill one or more of the
following core classes:
Religion (RT)/Humanities
History
Literature (LT)/Humanities
Fine Arts
Refer to Honors web site for clarification of Honors course designations such as RT or LT
Total Graduation Requirements—124 semester hours; 69 Nursing, 55 Non-Nursing
DAH/MA/eo Rev
6/09
51
TCU - HARRIS COLLEGE OF NURSING AND HEALTH SCIENCES
BSN Suggested Plan of Study for Honors Students Seeking
Kathryne McDorman Lower Division Honors and
Andrews Honors Scholar in Colloquia (Previously known as University Honors)
Kathryne McDorman Honors Scholar (Lower Division Honors) (15 credit hrs)
McDorman Scholars will have completed fifteen (15) hours of lower-division Honors courses, including six (6) hours of
Cultural Visions courses and at least nine (9) hours of Honors electives. First and second year students will enroll in at
least one Honors class per semester until these requirements are met.
Any university core or nsg prerequisite course offered with Honors designation may be taken to fulfill general honors
designated coursework
Freshman I
ENGL 10803 (Freshman Comp) ................................... 3
BIOL 20204 (Human A & P) .......................................... 4
PSYC 10213 .................................................................. 3
NURS 10043 (Survey of Prof Nsg) (Honors
course)………………………………………………..3
Honors course/elective ............................................... 3
16
Sophomore I
ENGL 20803 (Sophomore Comp) ................................. 3
BIOL 20233 (Microbiology) ............................................ 3
MATH 10043 (Elem Statistics) ...................................... 3
NURS 20033 (Teaching Strategies) .............................. 3
Honors Cultural Vision course ....................................... 3
NURS 20041 (Genetics/ Genomes in Nursing).… 1
16
Junior I
NURS 30714 (Adult Nsg I: Conc) .................................. 4
NURS 30783 (Adult Nsg I: Pract) .................................. 3
NURS 30813 (Psych-Mental Hlth: Conc) ...................... 3
NURS 30882 (Psych-Mental Hlth: Pract) ...................... 2
Honors interdisciplinary colloquia ……………….. 3
15
Freshman II
NTDT 20403 (Nutrition) ..................................................3
BIOL 20214 (Human A & P) ...........................................4
SOCI 20213 ....................................................................3
NURS 10303 (Growth & Development) ..........................3
Honors Cultural Visions course .................................. 3
16
Sophomore II
NURS 20224 (Fund / Assess: Conc)..............................4
NURS 20284 (Fund / Assess: Pract) ..............................4
NURS 20163 (Pharmacology) ........................................3
Honors course/elective .................................................. 3
Honors interdisciplinary colloquia ............................... ..3
Elective………………………………………………. 1
18
Junior II
NURS 30313 (Mat Nsg: Conc) .......................................3
NURS 30382 (Mat Nsg: Practicum) ...............................2
NURS 30413 (Pediatric Nsg: Concepts) ........................3
NURS 30482 (Pediatric Nsg: Practicum) .......................2
NURS 30632 (Gero Nsg)................................................2
Honors interdisciplinary colloquia ………………… 3
15
Senior II
NURS 40813 (CH Nsg: Conc) ........................................3
NURS 40882 (CH Nsg: Pract) ........................................2
NURS 40913 (RD & Nsg. Mgmt: Conc) .........................3
NURS 40984 (RD & Nsg. Mgmt: Pract)………….. 4
12
Senior I
NURS 40053* (Critical Inquiry) ...................................... 3
NURS 40114 (Adult II: Conc) ........................................ 4
NURS 40183 (Adult II: Pract) ........................................ 3
NURS 40632 (Res & Theory) ........................................ 3
Honors interdisciplinary colloquia ……………….. 3
16
This plan of study is intended to be flexible and less prescriptive.
The following core classes must fit into this plan of study. Most Honors classes will fulfill one or more of the following
core classes:
Religion (RT)/Humanities
History
Literature (LT)/Humanities
Fine Arts
Humanities Elective
Refer to Honors web site for clarification of Honors course designations such as RT or LT
All Nursing Honors students should attend Honors advising in addition to Nursing advising
Total Graduation Requirements—124 semester hours; 69 Nursing, 55 Non-Nursing
DAH/MA/eo Rev. 6/09
52
TCU - HARRIS COLLEGE OF-NURSING & HEALTH SCIENCES
Bachelor of Science Degree in Nursing (BSN)
Suggested Plan of Study
For Students Planning a Study Abroad Semester
Freshman Semester I
BIOL 20204 (Anat & Phys) (NSC) .............................. 4
ENGL 10803 (Freshman Comp) (WCO) ..................... 3
PSYC 10213 (General Psychology) ............................ 3
NURS 10043 (Survey of Prof Nsg) (CA) ..................... 3
MATH 10043 * (Elem Statistics) (MTH) ....................... 3
Freshman Semester II
BIOL 20214 ** (Anat & Phys) (NSC) ..................... 4
NTDT 20403 (Nutrition) ......................................... 3
SOCI 20213 (Introductory Sociology) (SSC,
CA) ..................................................................... 3
NURS 10303 (Human Development) (SSC) ......... 3
ENGL 20803 *** (Sophomore Comp) (WCO)…..…3
Total credit hrs ......................................................... 16
Total credit hrs ................................................... 16
Summer
______________________________________________________________________________________________
_________
BIOL 20233 ** (Microbiology) (NSC)………………….3
Humanities Elective……………………………….........3
Total credit hrs………………………………………...6
Sophomore Semester I
Sophomore Semester II
Humanities elective (HUM) .......................................... 3
Religious Traditions (RT)..;……………………………..3
Historical Traditions (HT) ............................................. 3
Free Elective ................................................................ 3
Fine Arts elective (FAR)…………………………….......3
NURS 20163 (Pharmacotherapeutics) ................. 3
NURS 20224 (Fund/Assess: Concepts) ............... 4
NURS 20284 (Fund/Assess: Practicum)............... 4
NURS 20033 (Teaching Strategies) (OCO)………3
NURS 20041 (Genetics/ Genomes in Nursing)…..1
Total credit hrs ......................................................... 15
Junior Semester I
Total credit hrs ................................................... 15
Junior Semester II
NURS 30714 (Adult Nsg I: Concepts) ......................... 4
NURS 30783 (Adult Nsg I: Practicum) ........................ 3
NURS 30813 (Psyc-MH Nsg: Concepts) ..................... 3
NURS 30882 (Psyc-MH Nsg: Practicum) .................... 2
Humanities Elective ..................................................... 3
NURS 30313 (Mat/Wom Hlth Nsg: Conc) ............. 3
NURS 30382 (Mat Nsg: Practicum) ...................... 2
NURS 30413 (Pediatric Nsg: Concepts) ............... 3
NURS 30482 (Pedi.Nsg: Practicum) ..................... 2
NURS 30632 (Gero Nsg) ...................................... 2
Literary Traditions (LT)……………………………..3
Total credit hrs ......................................................... 15
Senior Semester I
NURS 40053 # (Critical Inquiry in Health Care Delivery)
(SSC, GA)…………………………………………………3
NURS 40114 (Adult Nsg II: Concepts) ........................ 4
NURS 40183 (Adult Nsg II: Practicum) ...................... 3
NURS 40632 (Res & Theory in Nsg Prac) .................. 2
Elective ##……..…………………………………………2
Total credit hrs .................................................. 15
Senior Semester II
NURS 40813 # (Community Health Nursing:
Concepts) (CSV)…………………………………….3
NURS 40882 (Com Hlth Nsg: Practicum) ............. 2
NURS 40913 (Role Dev & Nsg Mgmt: Conc) ....... 3
NURS 40984 (Role Dev & Nsg Mgmt: Pract) ....... 4
Total credit hrs ................................................... 12
Total credit hrs ......................................................... 14
*
**
MATH 10023 is a prerequisite to MATH 10043 if lacking two years high school algebra
The following courses will satisfy the TCU CC requirement for Natural Sciences (NSC) Human Experiences and Endeavors: BIOL 20214 and
20233; applies to NURS-BSN only.
Microbiology at another 4 year institution might require prerequisites that you may not have.
*** Requires prearranged approval from English department to waive prerequisite of sophomore standing.
#
Writing Emphasis Course (WEM)
53
## Choice of elective will depend on other choices made in the HMVV and HEE
Total Graduation Requirements – 124 semester hours; 69 Nursing, 55 Non-Nursing
TCU, HARRIS COLLEGE-NURSING
ACCELERATED BSN TRACK
DEGREE PLAN ♦
Semester Hours
SUMMER I
NURS 30163 Introduction to Pharmacology (with 3-hr lab)
NURS 39113 Discipline and Practice of Professional Nursing
NURS 39123 Fundamentals of Professional Nursing
NURS 39184 Reflective Practice and Clinical Inquiry I
3
3
3
4
Total Hours: 13
FALL
NURS 30714 Adult Health Nursing I: Concepts
NURS 30813 Psychiatric-Mental Health Nursing: Concepts
NURS 39285 Reflective Practice and Clinical Inquiry II
NURS 40313 Maternity Nursing: Concepts
NURS 40632 Nursing Research and Theory
4
3
5
3
2
Total Hours: 17
SPRING
NURS 30632 Gerontological Nursing
NURS 40114 Adult Health Nursing II: Concepts
NURS 40413 Pediatric Nursing: Concepts
NURS 40813 Community Health Nursing: Concepts
NURS 49385 Reflective Practice and Clinical Inquiry III
2
4
3
3
5
Total Hours: 17
SUMMER II
NURS 40913 Role Transition and Nursing Management: Concepts
NURS 49488 Professional Nursing Residency
3
8
Total Hours: 11
Total Hours: 58
ACCELERATED BSN TRACK
Purpose of Program: To prepare previously degreed students for rapid entry into practice without
compromising Harris College-Nursing’s educational standards or quality of its graduates. The accelerated
program is designed specifically for students with degrees in other fields and a proven record of academic
success. The program is sequenced so that its graduates can segue seamlessly into Harris CollegeNursing’s Online Master's of Science in Nursing Program, if desired.
© 04-17-07 TCU’s Harris College, Nursing
54
♦ Does not apply to graduate students. See additional information in the graduate section of this handbook.
55
TEXAS CHRISTIAN UNIVERSITY – HARRIS COLLEGE OF NURSING & HEALTH SCIENCES
NURSING
HOW TO GRADUATE ON TIME
This is a summary of important points. It in no way is intended as a substitute for reading the Texas Christian University
Undergraduate Studies Bulletin. Students should read and be familiar with all policies and documents pertinent to their
degree and understand them fully.
I. Academic Advisement
equirements for a degree. HOWEVER,
THE STUDENTS THEMSELVES ARE RESPONSIBLE FOR UNDERSTANDING AND FULFILLING THE
REQUIREMENTS which are found in the Texas Christian University Undergraduate Studies Bulletin.
ore or shortly after enrollment as a nursing major. The counseling plan
should be updated each semester as necessary. If the counseling plan has not been updated the student should request the
advisor to do so as soon as possible. Students must notify their advisor when courses are not taken as scheduled, are
dropped or failed. Failure to do so may result in interruption of the student’s progression in the program.
ents. Prior to academic
advising, students must have a proposed schedule of courses ready for their advisor’s review. TCU students must
successfully complete a minimum of 124 semester hours. To earn a degree from TCU, 58 semester hours of residency are
required, of which 42 semester hours must be upper division. The student may not interrupt the last 30 hours of
coursework at TCU with courses taken at another institution.
II. Progression
-nursing). Continuing TCU nursing majors should file an
Intent to Enroll in First Practicum Courses by October 1 for the spring semester and February 1 for the fall semester.
Forms are available in the Harris College-Nursing administrative office.
courses are required to be eligible to enroll in clinical nursing courses, and the courses listed as concurrent with clinical
courses. A grade of “C-” is not acceptable.
-”, “D” or “F” in one nursing course for the nursing major must repeat the course and achieve a
minimum grade of “C” prior to progression. A student earning more than one “C-”, “D” or “F” (including repeated
courses) in nursing courses required for the nursing major will be discontinued from the nursing major. A student who is
repeatedly unable to either achieve or maintain a minimum GPA of 2.50 or better will be discontinued from the major for
failure to demonstrate progress. For additional information regarding nursing progression policies consult the Texas
Christian University Undergraduate Studies Bulletin.
lly completed NURS 20163 Pharmacotherapeutics must pass a 20-item dosage
calculation test by the end of the first week of each clinical semester. Students have two attempts to pass, the passing
score is 90% or above. If a student is unsuccessful, completion of NURS 30331 Dosage Calculations for Nurses is
required for a student to student remain in clinical course work.
summer sessions. Summer course offerings are subject to change at any time up to and including the first day of classes.
III. Transfer Coursework
enroll in any course at another institution. Students should not base their progression or graduation on permission being
granted to take coursework off campus. Students must notify their advisor when courses are not taken as
56
scheduled, are dropped or failed and should subsequently contact their advisor or Director to receive authorization to alter
the originally agreed upon permission form. Students who fail to adhere to this policy may not receive credit.
other colleges and universities do not alter the TCU GPA.
courses off campus only at a 4-year university.
forwarded to the TCU Admission’s Office for proper recording within one (1) semester of completion. Unless this is
done, the credits will not be applied toward a TCU degree and may prevent the student from progression. It is the
student’s responsibility to determine that the transfer courses have been recorded in the TCU Registrar’s Office.
transfer in a maximum of 12 credit hours from other institutions.
IV. Declaring the Nursing Major
approved.
been out of the nursing major at TCU for one or more years for any reason must apply to the
Director for readmission. Space availability will be one of the criteria used for the readmission decision as well as review
of the student’s previous academic record. If readmitted, students must meet the requirements of the Bulletin in effect at
the time of re-enrollment.
V. Enrollment
course offerings related to the nursing major and other information pertinent to their classification via the student’s TCU
email address. It is the student’s responsibility to periodically check his/her email for correspondence from Harris
College of Nursing & Health Sciences.
be placed in available sections during general registration times. This same method of placement will be used for students
who do not advance register. Students should notify the Director of their intent to continue enrollment to assure spaces
will be available.
nts whose
TCU cumulative GPA falls below the required cumulative GPA or if a student has not successfully completed
prerequisite courses. When this occurs the student should contact an advisor as soon as possible for re-advising.
inical facility availability or enrollment may require closing or rescheduling clinical or class
sections. Changes will be made in the fairest and most equitable manner possible. Although required courses are
guaranteed to be taught in the semester scheduled (except for summer), specific sections, days or times cannot be
guaranteed.
I have read and have had opportunities for questions to be answered concerning “How To Graduate On Time”.
__________________________________________ __________________________________________
Print Name Advisor Signature
__________________________________________ __________________________________________
Student Signature Date
57
HARRIS COLLEGE OF NURSING AND HEALTH SCIENCES
ACADEMIC ACTION/SPECIAL PERMISSION FORM
Name
TCU ID #
Date
Local address or box #
Phone
Address
City
Degree sought
Expected graduation date
Total Jr. college hours completed
Semester hours in progress
State
Zip
Major
Total hours completed to date
Semester hours completed at TCU
Approximate TCU GPA
You will be notified by email regarding your approval or denial; if you need a copy mailed to you please check this box [ ].
Email address
Adviser
PERMISSION REQUESTED TO (check only one per form):
___ Interrupt last 30 hours with transfer credit
___ Complete CLEP/other approved test for credit after having been at TCU
___ Complete additional courses at another college
or university after having been at TCU
___ Apply transfer credit to major
___ Complete correspondence course(s)
___ Take more than 18 hours; how many
Name of college/university you plan to attend.
___ Study abroad
___ Other
Date(s) to take course(s)
How many credit hours?
REASON FOR REQUEST:
TRANSFER
List transfer course number and name. Attach
PHOTOCOPY of course description from other
school’s catalog.
MAJOR
If you plan to apply the transfer course to your
major, list equivalent TCU course number and
name (attach syllabus). (Consult with the
department chair or your adviser if needed.)
 here if
course to be
considered for
satisfying TCU
CC or UCR.
Departmental recommendation:
___ Approved
___ Denied for reason(s)
___ Exceptions
Department Chair or Director of UG Programs / Date
OFFICE USE
58
Action taken:
___ Approved
___ Denied for reason(s)
___ Exceptions
Associate Dean, HCNHS or Nursing / Date
59
GENERAL INSTRUCTIONS
Approval of major coursework on this form will enable transfer work to appear as the TCU
equivalent on TCU internal transcripts. This will aid in the advising process as well as allow the
student to register online for courses requiring transferred prerequisites.
1. Forms which are not filled out completely and legibly will be returned to the student without
action being taken.
2. List the course number, title, and the school from which you have transferred credit. Many
schools have the same initials; to avoid confusion, use the name instead. To list more courses
than will fit on one form, use an additional form.
3. Attach a PHOTOCOPY of the course description from other school’s catalog.
4. Decisions about transfer equivalents are made in the Dean’s office. A departmental
recommendation and chairperson’s signature are required before action will be taken in the
Dean’s office.
5. When a decision has been made, a copy of the form will be mailed to you. If you will soon be
changing addresses, include the new address and the date at which it becomes effective.
6. The decision that a course will/will not meet the TCU CC or UCR is made elsewhere.
NOTES:
 Students transferring to TCU with 54 or more hours should request a degree plan by completing
the Request for Degree Plan and submitting it to the Dean’s Office, 214A Bass.

Effective fall 2006 ALL students who have a total of 54 hours must take classes at a four-year
university/college.

No more than a total of 12 hours can be taken outside of TCU.

Quarter hours will be converted to semester hours on the basis of one quarter hour = 2/3
semester hour.

If you are granted permission to transfer credit to TCU from another school, it is your
responsibility to see that the other school sends an official transcript of your work to:
Texas Christian University
Registrar’s Office
TCU Box 297004
Fort Worth, TX 76129
R09/2007
60
DISABILITY SUPPORT SERVICES
Texas Christian University provides reasonable accommodations for each student
who has a physical, medical psychological or learning disability. If you have a
disability and have not submitted information concerning that disability to the
university, please contact the office of the Coordinator for Students with Disabilities
during orientation or as soon as possible.
The Coordinator is eager to get to know you and assist you in determining
appropriate university services. It is to your advantage to file all medical or
assessment reports and met with the Coordinator before the semester begins.
For more information regarding disabilities services, contact:
Center for Academic Services
Texas Christian University
TCU Box 297710
Fort Worth, Texas 76129
(817) 257-7486
61
The William L. Adams Center for Writing
(R02-05-07)
The William L. Adams Center for Writing serves the entire TCU community – faculty and staff as well as
undergraduate and graduate students. This is a resource provided by the university to assist you. Staffed
by writing specialists and peer tutors, the Center offers one-on-one instruction. A tutorial may focus on a
specific piece of writing or on a selected writing skill (e.g., usage, punctuation, essay exams,
documentation, etc.). The Center is a non-threatening and supportive place where you can talk openly and
confidentially about your writing with someone who is informed but nonjudgmental.
To schedule an appointment with a writing specialist, call (817) 257-7221.
MAIN OFFICE:
Rickel Building, Room 244
Hours: Monday - Friday
(8:00 a.m. to 5:00 p.m.)
Phone: 817.257.7221
LIBRARY ANNEX:
[Open during fall and spring semesters only]
Hours: Monday - Friday
(2:00 p.m. to 5:00 p.m.
Hours: Saturday
(12:00 noon to 4:00 p.m.)
Hours: Sunday - Thursday
(6:00 p.m. to 9:00 p.m.)
Phone: 817.257.6520
Please refer to the Center for Writing’s web site, http://www.wrt.tcu.edu/main.html, for additional important
information!
62
Texas Board of Nursing
The mission of the Texas Board of Nursing is to protect and promote the welfare of the people of
Texas by ensuring that each person holding a license as a nurse in the State of Texas is competent
to practice safely. The Board fulfills its mission through the regulation of the practice of nursing and
the approval of nursing education programs. This mission, derived from the Nursing Practice Act,
supersedes the interest of any individual, the nursing profession or any special interest group.
As a nursing student and future registered nurse, it is your responsibility to be knowledgeable
concerning the activities of the Texas Board of Nursing. The best way to obtain this knowledge is
to consult the Texas Board of Nursing website at www.bon.state.tx.us
All topics found on the website are important. As a nursing student you should pay particular
attention to the following topics:
Good professional Character
Licensure of Persons with Criminal Convictions
Criteria and Procedure Regarding Intemperate Use and Lack of Fitness in Eligibility and
Disciplinary Matters
Declaratory Order of Eligibility for Licensure
Standards of Nursing Practice
Unprofessional Conduct
Criminal History Record Information for License Applicants
License Application
Examination
Grounds for Disciplinary Action
Disciplinary Authority of Board: Methods of Discipline
Notice and Hearing
Nursing students should complete and regularly review the jurisprudence course found on the
website at http://www.bon.state.tx.us/olv/je-course.html
The address of the Texas Board of Nursing is
Texas Board of Nursing
333 Guadalupe, Suite 3-460
Austin, Texas 78701-3944
Fax: (512) 305-7401
Phone: (512) 305-7400
63
NURS MSN Table of Contents
Content
Page
Welcome.................................................................................................................................................... 64
Mission Philosophy and Program Goals of the Graduate Nursing Program .......................................... 64-65
Accreditation, Certification and Licensure ................................................................................................. 65
Graduate Nursing Enrollment and Progression Policies ............................................................................. 65
Expectations of All Graduate Nursing Students in Concepts and Practica Courses
Attendance in Online Courses and Clinical Practica .............................................................................. 65
Examinations ......................................................................................................................................... 66
Final Examinations ................................................................................................................................ 66
Quizzes/Study Questions/Assignments ................................................................................................. 66
Medication Administration...................................................................................................................... 66
Professional Attire ................................................................................................................................. 66
Student Fees ............................................................................................................................................. 66
Required Health Insurance ........................................................................................................................ 66
National Association of Clinical Nurse Specialists ...................................................................................... 67
Resources
Employment .......................................................................................................................................... 67
Learning Center..................................................................................................................................... 67
Sigma Theta Tau International .............................................................................................................. 67
Advising ..................................................................................................................................................... 67
Required Forms ......................................................................................................................................... 67
MSN Student Checklist ..................................................................................................................... 68-69
Informed Consent and Assumption of Risk ....................................................................................... 70-71
Unsafe Nursing Practice ........................................................................................................................ 72
HIPAA Policies ...................................................................................................................................... 73
Student Completion of Training Regarding Harris College-Nursing Policies and
Procedures Regarding HIPAA (MSN) .............................................................................................. 75
Use of Standard Precautions (MSN) ...................................................................................................... 76
Written Assignments ............................................................................................................................. 77-78
The Professional Project ....................................................................................................................... 78-81
Online Program Information .................................................................................................................. 81-82
Graduate Nursing Program Policies ........................................................................................................... 82
Admission Policy ................................................................................................................................... 82
Progression Policy ................................................................................................................................. 82
Program Interruptions for Life Events Policy .......................................................................................... 83
Residency Policy ................................................................................................................................... 83
Transfer Credit Policy ............................................................................................................................ 83
Graduation Related Policies ............................................................................................................. 83-84
Academic Conduct Policy and Grievance Procedure ............................................................................. 84
Policy on Program Administrative Oversight .......................................................................................... 84
Drug Testing Policy (effective summer 2006) ........................................................................................ 85
Harris College-Nursing’s Selection of Company to perform Drug Testing/
Criminal Background Check ....................................................................................................... 85-87
TCU’s Institutional Policies/Policies of Other Departments or Programs ................................................ 88
Policy for Faculty Publishing with Students ............................................................................................ 88
Tuition Discount Policy .......................................................................................................................... 88
Policy for Qualifications, Selection, Orientation, and Evaluation of Clinical Agencies and Preceptors .... 88
CNS and Educator Programs’ Full Time Courses of Study ........................................................................ 93
CNS and Educator Programs’ Part Time Courses of Study .................................................................. 94-95
BNE Rules and Regulations Applicable to the Graduate Program ...................................................... 96-131
64
WELCOME
Welcome to Texas Christian University (TCU) and Harris College of Nursing and Health Sciences (HCNHS)
Graduate Nursing Program. During your graduate study you will learn the art and science of graduate
professional nursing, gaining career skills designed to carry you well into the 21st century. This addendum
to the Harris College-Nursing’s Student Handbook contains information that applies to graduate nursing
students at TCU. In order to provide the best educational preparation for you, all of us—faculty, staff, and
students—are accountable for the information contained in the Handbook.
We value your choice to become a graduate student in our program, recognizing the privilege and
responsibility you have granted us. Welcome to Harris College-Nursing’s Graduate Program.
MISSION, PHILOSOPHY, AND PROGRAM GOALS OF THE GRADUATE NURSING PROGRAM
The Mission, Philosophy, and Program Goals of the Graduate Nursing Program are:
Mission
To prepare professional nurses at the graduate level to identify and respond with competence to multiple,
complex human healthcare needs.



Graduates serve society though advanced professional nursing roles and provide ethical leadership in
practice, administration, teaching and scholarship.
The graduate faculty is dedicated to the facilitation of upward educational mobility for registered nurses
(integrating online teaching methodologies), and to the promotion of an environment that encourages
lifelong learning.
The graduate faculty further affirms a commitment to professional expertise in advanced practice and
civic and professional responsibilities in a global society.
The graduate program is designed to meet the needs of registered nurses with either an associate’s degree
or bachelor’s degree in nursing interested in obtaining a Master of Science in Nursing degree.
Philosophy
The philosophy of the faculty of the TCU graduate nursing programs affirms that individuals are holistic
beings who possess inherent worth.






The faculty believes that the graduate education of the professional nurse should prepare an advanced
practice nurse or nurse educator who exhibits qualities of mind and character that are necessary to live
a fulfilling life, act in the public interest locally and globally, and promote health and the nursing
profession.
The teaching/learning process is multidimensional and interactive, involving affective, cognitive and
psychomotor changes.
Graduate education enhances the ability of persons to think critically and improve themselves, the
profession, and society.
Graduate education broadens core competencies, strengthens expertise in clinical focus areas and
increases knowledge of professional nursing for advanced nursing practice or for preparation to teach
future nurses.
The TCU Nursing faculty embrace the professional values of altruism, autonomy, human dignity,
integrity, and social justice.
Advanced nursing practice, conduct, and relationships are guided by professional standards and the
ANA Code of Ethics.
65


Sound research and/or theory-based clinical judgments characterize the practice of the graduate
professional nurse in designing, coordinating, implementing, managing, and providing delivery of safe,
humanistic care in and across diverse environments.
Sound research and / or theory based educational practices characterize the practice of the graduate
nurse educator in designing, planning, implementing and evaluation of nurse education in all
educational settings.
Program Goals
 Support the University’s Mission, Vision, and Core Values.
 Prepare graduates who are able to design and evaluate programs of care or education to meet the
unique, multiple, and complex human health needs of a global society.
 Promote values and behaviors that encourage respect for diversity, acknowledge human worth and
dignity, and support advanced professional nursing practice.
 Foster a commitment to the necessity of continued learning, thinking critically, and continuing to grow
personally and professionally.
 Contribute to the nursing profession and to society through individual scholarship, leadership, and
service.
ACCREDITATION AND CERTIFICATION
The Commission on Collegiate Nursing Education (CCNE), One Dupont Circle, NW, Suite 530,
Washington, DC, 20036-1120, 202-887-6791, granted a five year full accreditation to the graduate program
in 2002. The program will undergo an accreditation visit in November 2007 to maintain accreditation.
Graduates of either the CNS or Nurse Educator programs will be eligible to sit for national certification
programs. Graduates of the CNS program will be eligible for advanced practice recognition in Texas. The
rules and regulations for practice are available at the Board of Nurse Examiners for the State of Texas
website (http://www.bne.state.tx.us/). Excerpts are included at the end of this section.
The American Nurses Credentialing Service certifies Adult Health (Medical-Surgical) CNSs. Their web
site for information about the examination is: http://www.nursingworld.org/ancc/
GRADUATE NURSING ENROLLMENT AND PROGRESSION POLICIES
The University policies for enrollment, progression, probation, and suspension can be found in the TCU
Graduate Studies Bulletin, which can be found at: http://catalog.tcu.edu/graduate/. The Nursing policies are
found in the HCNHS section of the Bulletin.
EXPECTATIONS OF ALL GRADUATE NURSING STUDENTS IN CONCEPTS AND PRACTICA
COURSES
Attendance in Online Classes and Clinical Practica
Students are required and expected to attend all online classes and practica. If you are unable to do so,
you must notify the faculty and, if appropriate, the preceptor.
Students are expected to participate in online class discussion. Each student will be accountable for all
assigned objectives. Some classes may be led by a student, in which case, you may determine what you
will use to generate discussion. The student will be held accountable for all content taught in previous
courses. The APA format will be used for all written material in all classes. The APA format will be used for
all written material in all classes.
Students are expected to adhere to the Academic Conduct Policy of the University
http://catalog.tcu.edu/graduate/.
As part of the clinical experience students have the opportunity to work in several clinical settings and
with numerous clients. As professional nurses, students are expected to keep confidential all information
66
entrusted to them by clients, peers, and colleagues in a practicum setting. The student who demonstrates
unprofessional behavior can be administratively removed from or will fail the practicum course. Students
are expected to be on time to practicum and to be prompt for any appointments made. Students are
expected to conform to the standards of nursing practice as stated in the Texas Statutes Regulating the
Practice of Professional Nursing, or the nursing practice act of the state where they live and practice. At
the beginning of each semester, each student must review basic information regarding use of standard
precautions. The student will turn in a signed statement to the effect that the student is responsible for
implementing the practice. Clinical attendance is mandatory. Clinical preparation may require reading,
researching, or written assignments prior to arrival at practicum.
Examinations
Examinations are listed on the tentative class schedule. Students will take each examination at the time
scheduled. In the event of extenuating circumstances, the student must contact the faculty prior to period
the examination is being taken. Arrangements to make up the examination will be made at that time. A
student who fails to comply with the above will not be permitted to take the examination, and the grade will
be recorded as zero.
Final Examinations
Final examinations will be given on dates and times as specified by the TCU Schedule of Classes.
University policy prohibits changing of exam dates from the printed schedule unless there are more than
two examinations within a 24-hour period. Individual concerns need to be addressed early in the semester
to the lead teacher of an individual course.
Quizzes/Study Questions/Assignments
Students are responsible for preparing for each assignment. All assignments are due on the date specified
on the class schedule. If an extension needs to be made for an assignment due to extenuating
circumstances, the faculty of the course must be notified in advance of the due date to make an appropriate
decision on the request. Any assignment turned in late may lose points as noted on the evaluation form of
the particular assignment.
Medication Administration
As registered nurses, students are able to administer medications under their license during the clinical
practicum courses. Students are responsible for safely administering medications and for following the
rules and regulations of the BNE and the clinical practicum facility.
Professional Attire
Students are to be professionally attired at all times when representing themselves as HSN students.
Students are expected to follow the dress code of the facility and to wear a TCU graduate student nametag
when completing practicum hours.
STUDENT FEES
In addition to tuition and University fees graduate nursing students have the following:
 Liability insurance ............................................................................. $10/semester
 Clinical course fee ................................................................................$70/course
REQUIRED HEALTH INSURANCE
All graduate students carrying nine or more semester hours MUST have health and accident insurance
coverage. That coverage can be offered either through the plan offered by the University or through your
private individual or family plan.
67
NATIONAL ASSOCIATION OF CLINICAL NURSE SPECIALISTS
All students are expected to join the National Association of Clinical Nurse Specialists as student members.
This organization will provide you with a journal, networking opportunities, publication possibilities,
scholarship opportunities, presentation possibilities, and employment advertisements. An online application
is available at http://www.nacns.org/ .
RESOURCES
Employment
Dependent upon enrollment and the nursing program faculty needs, opportunities to serve as teaching
assistants and research assistants may be available to graduate students. Contact the Director of
Graduate Studies if you are interested in serving in either of these positions. Salary is dependent on the
hours and requirements of the positions.
Learning Center
A Learning Center in the nursing building is available to all graduate students to enhance independent
learning and provide access to computers, audiovisual materials, simulation, and a practice lab for
assessment skills. No food or drink is allowed.
Sigma Theta Tau International
Since 1970, the Beta Alpha Chapter of the International Honor Society for Nursing, Sigma Theta Tau, has
selected members from the Harris School of Nursing student body on the basis of academic merit.
Graduate students are encouraged to seek membership if have a grade point average of 3.5 on a 4.0 scale
and have completed ¼ of the program.
ADVISING
Advising for graduate students is the responsibility of the Director of Graduate Studies or her designee.
Harris College-Nursing designates an administrative assistant to oversee compliance with University
requirements for the Master’s degree. Questions that are related to part-time options, grade concerns,
program progression, and complaints/grievances should be discussed with the Director of Graduate
Studies. Questions that are related to course codes for registration, scholarships and stipends, paperwork
for progression and graduation, and the student’s permanent file should be discussed with the College
administrative assistant.
REQUIRED FORMS
All students involved in a clinical practicum coursework must sign the following required forms in each
semester of clinical:
 The TCU Informed Consent and Assumption of Risk Form
 Unsafe Nursing Practice Form
 HIPAA Policies Form
 Standard Precautions Form
Other forms may need to be signed. The following pages contain the Forms Checklist and the required
form.
68
MSN Student Checklist
Student Name:
Start Date:
Expected End Date:
Status: Full Time
Part Time
Required Once Upon Admission:
1. Hepatitis B vaccination or signed waiver form
2. Evidence of Tetanus vaccination or signed waiver form
3. Evidence of current health insurance
Dates:
Required Upon Admission and Renewal Upon Expiration:
1. BCLS certification (copy of card must be on file)
2. Evidence of TB test
Dates:
Required Once within 30 Days of First Clinical Course (Assessment/Spring):
1. Criminal background check
2. Drug screen
Dates:
Required Once a Year in Clinical Courses:
1. Completed Preceptor Agreement
2. Completed Biographical Data Form
3. Preceptor Resume (may copy previously submitted resume)
Dates:
Required on Admission and Prior to Each Clinical Course:
1. Unencumbered RN License
A. Admission
B. Assessment course
C. Combined practicum
D. CNS II practicum
E. CNS III practicum
F. Optional Diagnostic Reasoning course
2. Signed Student Assumption of Risk Form
A. Admission
B. Assessment course
C. Combined practicum
D. CNS II practicum
E. CNS III practicum
F. Optional Diagnostic Reasoning course
3. Signed Standard Precautions Form
A. Admission
B. Assessment course
C. Combined practicum
D. CNS II practicum
E. CNS III practicum
F. Optional Diagnostic Reasoning course
Dates:
Dates:
Dates:
69
4. Signed Unsafe Nursing Practice Form
A. Admission
B. Assessment course
C. Combined practicum
D. CNS II practicum
E. CNS III practicum
F. Optional Diagnostic Reasoning course
5. Signed HIPAA Form
A. Admission
B. Assessment course
C. Combined practicum
D. CNS II practicum
E. CNS III practicum
F. Optional Diagnostic Reasoning course
Other
Dates:
Dates:
70
TCU, HARRIS COLLEGE-NURSING
Informed Consent and Assumption of Risk (MSN)
TCU is a non-profit educational institution. References to TCU include ―TCU‖, its trustees, officers, officials,
employees, volunteers, students, agents, and assigns.
I (print your name)
understand I am to participate in the
(henceforth referred to as the Program).
I fully understand and appreciate the dangers, hazards and risks inherent in participating in the Program, in
the transportation to and from the Program, and in any independent research or activities I undertake as an
adjunct to the Program.
I agree that participating in any activity is an acceptance of some risk of injury and/or loss or damage of
property. I agree that my safety is primarily dependent upon my taking proper care of myself. I understand
that is my responsibility to know what I will need for the Program and to provide what I will need. I agree to
make sure that I know how to safely participate in any activities, and I agree to observe any rules and
practices, which may be employed to minimize the risk of injury. I agree to stop and seek assistance if I do
not believe I can safely continue any activity. I will not wear or use or do any thing that would pose a
hazard to myself or others, including using or ingesting any substance which could pose a hazard to myself
or others. I agree that if I do not act in accordance with this agreement, I may not be permitted to continue
to participate in the Program.
In consideration of my participation in this Program, I agree as follows:
Specific Hazards of Travel or Program
Despite precautions, accidents and injuries can occur. I understand that traveling, doing fieldwork or being
in a large city may be potentially dangerous, and that I may be injured and/or lose or damage personal
property as a result of participation in the Program. Therefore, I ASSUME ALL RISKS RELATED TO THE
ACTIVITIES including, but not limited to:
Death, injury or illness from accidents of any nature whatsoever, including, but not limited to, bodily
injury of any nature, whether severe or not, which may occur as a result of participating in an activity or
contact with physical surroundings or other persons; arising from travel by car, bus or any other means;
death injury or illness including food poisoning arising from the provision of food or beverage by
restaurants or other service providers.
Theft, loss or damage of my personal property while in transit or participating in the Program.
Natural disaster or other disturbances, and alteration or cancellation of the Program due to such
causes.
Most trips to hospitals, schools and community service centers require travel through or parking in high
crime areas. Please review the attached safety guidelines.
(Specific dangers endemic in this Program’s area of travel or endemic to the Program.)
Institutional Arrangements
I understand that TCU is not an agent of, and has no responsibility for, any third party which may provide
any services including food, lodging, travel, or other goods or services associated with the Program. I
understand that TCU may provide these services only as a convenience to participants and that
accordingly, TCU accepts no responsibility, in whole or in part, for delays, loss, damage or injury to persons
or property whatsoever, caused to me or others prior to departure, while traveling or while staying in
designated lodging. I further understand that TCU is not responsible for matters that are beyond its control.
I acknowledge that TCU reserves the right to cancel the trip without penalty or to make any modifications to
the itinerary and/or academic program as deemed necessary by TCU.
71
Independent Activity
I understand that TCU is not responsible for any loss or damage I may suffer when I am traveling
independently or I am otherwise separated or absent from any TCU activity. In addition, I understand that
any travel that I do independently on my own before or after the TCU sponsored Program is entirely at my
own expense and risk.
Health and Safety
I have been advised to consult with a medical doctor with regard to my personal medical needs. I state that
there are no health-related reasons or problems that preclude or restrict my participation in this Program. I
have obtained the required immunizations, if any. I recognize that TCU is not obligated to attend to any of
my medical or medication needs, and I assume all risk and responsibility. I agree to pay all expenses
relating thereto.
TCU Rules, Regulations and Policies
I agree to obey and comply at all times with all of the rules, regulations, codes and policies of TCU while
participating in the Program. I agree to notify my professor immediately of any injury or loss.
Travel Changes
If I become separated from the Program group, fail to meet a departure airplane, bus, or train, or become
sick or injured, I will, to a reasonable extent, and at my own expense seek out, contact, and reach the
Program group at its next available destination.
Signature
I indicate that by my signature below that I have read the terms and conditions of participation and agree to
abide by them. I have carefully read this Informed Consent and Assumption of Risk Form and
acknowledge that I understand it. My signature below indicates that I have read and freely signed this
agreement, which take effect as a sealed instrument.
IMPORTANT – READ ENTIRE AGREEMENT BEFORE SIGNING.
Signature of Program Participant
Date
Signature of Parent or Legal Guardian
(If student is a minor)
Date
I:\09300\0019\AP1675.WPD
72
TCU, HARRIS COLLEGE-NURSING
Unsafe Nursing Practice (MSN)
I,
have read and understand the Unsafe
PRINT full name
Nursing Practice policy in the TCU, Harris College Nursing Student Handbook. I understand that, while not
specifically stated in the policy, errors in judgment underlie the behaviors that endanger the welfare of the
client. Examples of errors in judgment may include giving a medication without following the ―5 Rights‖ or
performing a treatment or procedure at the direction of a client, staff nurse, nurse manager, or a physician
without first clarifying directions with the clinical preceptor before I intervene. I have had an opportunity to
have my questions concerning unsafe nursing practice answered. I understand that a violation of this
policy will lead to a grade of no credit (failure) in the course and immediate withdrawal from the clinical
practicum.
Student signature
Date
73
TCU, HARRIS COLLEGE-NURSING
Student Policies: Health Insurance Portability and Accountability Act (HIPAA)
Policies: Access, Use, and Protection of Health Information obtained during the course of Clinical
Education
1. All students must sign a Harris College-Nursing Confidentiality Statement prior to accessing patient files
in any agency used for clinical education.
2. All student documents related to patient assignments (journals, care plans, papers, assignment sheets,
etc) must be protected to assure privacy of the patient(s) information by de-identifying the health
information. Your course faculty will tell you the de-identification method to be used.
3. Students should maintain the de-identification of health information when communicating with faculty,
one another, or any other entity through any means including electronic means.
4. Any documents submitted to faculty should contain no protected health information (PHI) or the
information should be de-identified. For example: course papers, care plans, interview information, etc.
5. If protected health information is re-identified for any reason, it is deemed to be protected health
information and is subject to the applicable privacy protections. The student is responsible for
maintaining the security of the re-identified information.
7. Per the TCU-Clinical Agency Identity Verification Policy, only students wearing the approved TCU
identification badge will be granted access to patient information by the clinical agency.
8. Student IDs are to be worn in a visible location on the uniform, street clothing, or scrubs when
representing self as a TCU student nurse. The ID is not to be worn at any other time, such as during a
work shift in a hospital setting.
9. There should be no disclosure of PHI of patients by HSN students. A student should consult the course
faculty if a student has a question about PHI related to disclosures required by law, disclosures for
public health activities, disclosures about victims of abuse, neglect or domestic violence; law
enforcement purposes, disclosures about decedents, disclosures for cadaver organ, eye, tissue
donation, disclosures to avert a serious threat to health or safety, disclosures for specialized
government functions, disclosures for workers' compensation.
10. If documents containing PHI are in use by students (for example, in the hospital unit, HSN computer
lab, etc.) the document(s) must be shielded so others may not see the information. If the person using
the documents leaves the room, the documents must not be left on top of the desk for others to see.
Locking the documents in a secure file is recommended.
11. If faxing, copying or printing documents containing PHI it is the user's responsibility to assure protection
of the PHI.
12. Documents containing PHI should only be shredded by the person authorized to have the PHI.
Policy: HIPAA Regulations and HSN Research and/or Professional Projects
1. Any student research or professional projects should maintain the protection of health information
collected during the duration of the project by including no identifying patient information on project
instruments. If a code is used to re-identify the participant information, the codebook must be
maintained in a locked, secured file. If an informed consent document is signed, the documents should
be maintained in a locked, secured file apart from any patient/subject information. Informed consent
documents should be submitted to the HSN Administrative Office at the end of the project. The
documents will be stored according to TCU Safeguards in Human Research guidelines.
2. In the event protected health information collected during a research project was disclosed, the student
and the student’s committee chairperson should report the disclosure to the HSN Privacy Official. The
Privacy Official will determine if a disclosure of PHI was made for 50 or more individuals involved in a
research project. If so, an accounting of the disclosure should include the following: a) name of research
activity b) a description of the project in plain language including the purpose for the research and
selection of criteria for the records c) a description of the type of PHI disclosed d) the date or period of
time of the disclosure e) name, address and phone number of the sponsor of the research f) the name
74
of the researcher to whom the PHI was disclosed g) a statement that the PHI of the individual may or
may not have been disclosed during the research activity.
If there were fewer than 50 individuals involved in the research, the Privacy Official must provide an
accounting for every disclosure of PHI for each individual whose PHI was disclosed.
In addition, if an individual involved in a research study of 50 or more individuals requests an accounting
for the disclosure of PHI pertaining to the individual, the Privacy Official must make a reasonable attempt to
satisfy this request.
HIPAA Privacy Official
1. The Director of the Harris School of Nursing is the Privacy Official, but may delegate his or her duties to
others if so desired. The appointment is continuous and will transfer when and if a new Director is
named.
2. The duties of the Privacy official include: a) Maintaining program compliance with HIPAA regulations b)
developing HSN policies and procedures related to HIPAA regulations c) maintaining documentation of
complaints and sanctions d) overseeing HIPAA training program.
3. The chain of command under the Director, Harris School of Nursing, as the Privacy Official is student to
faculty, faculty to lead teacher of course (if applicable), and faculty/lead teacher to Director. At times it
may be appropriate for the student and faculty/lead teacher to meet simultaneously with the Director.
Policy: Required Training Regarding HIPAA Regulations and Policies for All Harris College-Nursing
Students
1. All HSN students enrolled in practicum courses for the first time will complete a training program
regarding HIPAA regulations and policies during the first week of the academic semester. Each will be
asked to sign a form indicating understanding of the HSN policies and procedures related to HIPAA and
the Harris School of Nursing Confidentiality Statement.
2. If a breach in confidentiality occurs, the student will complete a retraining program as soon as possible
following the incident.
3. All students will complete retraining within 1 month following a significant change in privacy practices.
Policy: Sanctions for Violating Harris College-Nursing Policies and Procedures related to HIPAA
1. A complaint regarding a breach in patient privacy may be brought to the Privacy Official with the
assurance that no retaliatory measures will be taken against the person bringing the complaint.
2. The Privacy Official will document the complaints received and their disposition and maintain the
document in a locked, secured file.
3. Students who violate the protection of health information are subject to sanctions, which may include,
but are not limited to: unit or course grade reduction; failure of course; suspension from program.
Effective fall 2003, Policy in Harris College-Nursing Student Handbook
75
TCU, HARRIS COLLEGE-NURSING
Student Completion of Training Regarding Harris College-Nursing
Policies and Procedures Regarding HIPAA (MSN)
I,
have completed the required reading of the
PRINT full name
Harris College-Nursing policies and procedures regarding HIPAA. I understand that if I have questions I
should ask my course faculty for clarification or information.
Student signature
Date
Effective fall 2003
Clinical Course Faculty will initiate and collect student completed forms during course orientation.
Completed form to be placed in student’s file in Harris College-Nursing’s Administrative office.
76
TCU, HARRIS COLLEGE-NURSING
Use of Standard Precautions (MSN)
I,
have read the assigned reading
PRINT full name
in my nursing textbook titled "Standard Precautions" and have viewed the videotape shown in class (NURS
20033, 20224, 20282, or 20284).
I have had an opportunity to have my questions answered about use of universal precautions in health care
settings.
I agree to implement these precautions consistently.
Student signature
Date
77
WRITTEN ASSIGNMENTS
1. In all written assignments, follow APA format for citing references for your work.
2. Be sure to cite any used article or book in the body of paper and reference page.
3. Anytime the information could not have been known without reading it in a source, the source
needs to be cited.
4. Direct quotes are rarely used in APA. Only use them if the effect is lost by paraphrasing.
5. If using direct quotes, frame that text within quotation marks and also cite the page number of the direct
quote.
6. All assignments should have a right-justified running head with your name.
The APA website is located at:
http://www.uvm.edu/~ncrane/estyles/apa.html
Sections of the Paper
1. THE TITLE PAGE
 Center the information in the middle of the paper.
 Double-space the entries.
 Include the following information:
Project Name
Student Name
―Professional Project for Master of Science Degree in Nursing‖
―Texas Christian University‖
―Harris School of Nursing‖
Date in Month and Year
2. BODY OF THE PAPER
 Do not hyphenate words at the end of lines.
 Do not leave one line of a paragraph hanging by itself on the top of a page. Bring another line over
so there are at least two lines of a paragraph at the top of a page.
 Do not leave one line of a paragraph hanging by itself on the bottom of a page. If you cannot fit at
least two lines of the paragraph on the bottom.
 Use one and a half inch margins all around paper.
 Number pages in the top right hand corner.
 A running head is part of APA format but not required for the project.
 Use subheadings.
 If emphasis is needed for content or words, use bold type or italics instead of quotation marks.
 Numbers below the number 10 are written out, numbers 10 or above are written in numeral form.
 Use author's name, not editor's name, in text and reference list.
 Use quotation marks around direct quotes.
 Cite a page number for direct quotes.
 Proof for errors in syntax, "typos," and semantics.
 Use headings and subheadings when paper becomes lengthy or complex.
 Avoid use of flowery words, jargon, and derogatory words.
 Avoid use of wording that shows prejudice toward age, race, sex, or ethnic background.
 Use "think" or "believe" instead of "feel" in most cases.
 Write out words for initials used the first time (e.g. HCFA)
 Avoid long rambling sentences.
 Make sure subject and verb agree in number.
 Use "their" if want to have a personal possessive; use "there" for directional message.
 Capitalize proper nouns such as Social Security, Medicare, and Medicaid.
 Use contractions appropriately (e.g. don't).
 Use possessives to show ownership (e.g. persons' boat).
78
 Use regime (political definition) instead of regimen (medical definition) appropriately.
 Insure that data has a plural verb (datum is singular).
 Use quotes only for quotable text; use italics, underlining, or bold print for emphasis.
 Avoid the use of the word hopefully.
 Avoid input and output (computer jargon) unless discussing computers.
 Use since (if something is related to time); use because (if something is for a reason).
3. REFERENCE LIST
 A reference list, not a bibliography is used in APA format.
 All references in text must be listed on reference list.
 APA appropriate format must be used for abbreviations and punctuation.• All authors must be cited
for a reference unless the number of authors is six or more (see APA manual for specifics).
 Use author's name, not editor's name.
THE PROFESSIONAL PROJECT
Professional Project Criteria
If there is one term that best describes the Clinical Nurse Specialist (CNS) it is ―change agent.‖ CNSs focus
on changing practice, knowledge and even organizations. They do this through research, education,
consultation, management, and advanced clinical practice. This paper reflects the body of work acquired in
the CNS program at TCU that reflects the CNS as a change agent incorporating these multiple roles.
The proposal focuses on an innovative solution for a problem in the clinical setting that an Adult
Medical-Surgical CNS has the knowledge and skill to resolve. Everyday people in all industries around
the world come up with innovative solutions to real problems and implement these ideas without ever
looking at the literature or evaluating the evidence. The same is true in health care.
In healthcare, this is not a good process for change for several reasons. First, and most important, are
threats to patient and staff safety that are more likely to arise with unplanned change. Second, unplanned
change is likely to be more costly and yield undesired results. Solving problems – especially patient care
problems - must be done through a systematic method that affords the best opportunity for patient safety
and outcomes. It is a great opportunity for Clinical Nurse Specialists to make significant contributions to
healthcare organizations.
This paper reflects the student’s synthesis of their graduate studies at TCU. The outcome of the
project should be a recommendation for practice implementation, further research on the topic
and/or policy change. Section headings, outlined below, must appear in order in the paper.
Title Page
1. Contains project title (but does not read ―Title Page‖), student’s name, project chair’s name and name
2nd faculty member, Harris College-Nursing, Nursing Graduate Program, Texas Christian University,
semester and year in which final paper submission occurs.
2. The title page remains the same on the final paper except the date reflects the semester and year in
which approval of the final paper occurred. (Why do we need this sentence? It is said in number 1.)
Abstract
1. The heading reads ―Abstract‖.
2. The abstract presents a complete and concise overview of all phases of the proposed project. Abstract
subtitles should be bolded and include: Statement of the Practice Problem, Proposed Innovative
Solution, Methodology, Findings, and Conclusions and Recommendations.
3. The abstract should be placed at the beginning of the paper but written when the proposal or final paper
are completed.
4. The abstract provides an important and concise summary of the paper.
79
Introduction
1. Describe the practice or healthcare system problem or issue that the CNS can resolve.
a. Be sure to include and describe the population of interest, adults.
b. The description of the problem issue may focus on age (e.g. young adults, middle age, elderly),
disease (e.g. heart failure), system (e.g. cardiovascular disease), or symptom (e.g. pain).
2. Provide your rationale, including any literature, which justifies or substantiates this to be a current
problem in health care.
3. Provide support that the problem or issue is important for a CNS to address (e.g. high volume, high
cost).
4. Describe the proposed innovative solution and the way in which it will resolve the problem or issue.
This would be similar to writing a hypothesis in research that proposes ways to solve the problem.
5. Discuss the background and justification from the literature for the CNS to address this problem. (e.g.
Hamric (2003) states that clinical nurse specialists . . . )
Methodology
1. Evidence-based practice model
a. Select and describe the evidence-based practice model used to guide the evidence search.
b. Examples include:
(1) Iowa Model of Evidence-based Practice to Promote Quality Care
http://www.uihealthcare.com/depts/nursing/rqom/evidencebasedpractice/iowamodel.html
(2) ACE Star Model of Knowledge Transformation http://acestar.uthscsa.edu/Learn_model.htm
c. The model guides you in identifying and selecting sources of evidence and thus should be followed
throughout the rest of the paper.
2. Search method
Note: The evidence for the proposed innovative solution should be sufficient to support its use.
Therefore, you must provide a sufficient and compelling body of evidence for the proposed solution. In
the proposal, this section needs to address how you plan to identify, review and evaluate the evidence
consistent with the identified model.
Note: There may be no “direct” evidence for your innovative solution as such can be the nature of
innovation. In that case you should search for evidence that indirectly and realistically supports your
solution. An overly simple example might be reducing infection in PICC lines by using antibacterial
coated cap locks. You may find there is no research in that area but can locate this intervention being
used with central intravenous lines. You can review that evidence and provide a rationale as to how and
why it supports your innovative solution.
a. State the specific purpose for the review of the evidence. (e.g. determine the safety of the
innovative solution, determine the cost-effectiveness of the innovative solution), etc.
b. From the purpose, clearly and explicitly state the review question(s) that will guide you in your
review of the evidence. (e.g. Is the ―innovative solution‖ safe in adult patients with cardiovascular
disease?
c. Identify and define the concepts for the review. (e.g. safety, ―innovative solution,‖ adult inpatients
admitted with myocardial infarction) These will become your search terms and should be identified
as such in your paper.
d. Identify search strategies to be used.
(1) Board of Nurse Examiners
(a) It is important to understand if the BNE has issued any advisory or position statements on
the proposed solution.
(b) It is important to include this finding in your paper.
(2) Electronic databases (Examples)
(a) CINAHL
(b) OVID
(c) Others
80
(3) Published practice guidelines
(a) National Guideline Clearinghouse (www.ngc.gov)
(b) Professional organizations
(4) Researchers or experts in the field
(a) Students are encouraged to network with researchers and experts.
e. State inclusion and exclusion criteria.
(1) Exclude pediatric patients or patients under 18 years.
(2) You may also be limiting your search to certain population characteristics such as age groups,
gender, races or the research to certain years.
(3) Provide sound rationale for your choice of specified exclusion and inclusion criteria. (e.g. the
innovation is related solely to women)
f. Use an accepted schema to assess levels of evidence of each critiqued research study. Identify why
this schema was chosen. (e.g. part of model, used by AHRQ, etc)
The proposal ends here. Once it is approved by your committee you complete your work as
approved in the proposal and continue your work using the following guideline.
Critique of the Evidence
Summarize the evidence in a table(s). This allows the reader, including you, to readily review and evaluate
the evidence. The essential components of each piece of evidence must be included so that the reader can
evaluate the merit of the evidence. For example, a table of reviewed research articles might include column
headings such as the authors, year, sample size and description, research methods and design, and major
findings.
It is important to include a narrative whereby you draw conclusions from the evidence and include the
rationale as to support your conclusions. An example might be, ―A review of the empirical evidence yielded
13 randomized controlled trials published between 2000 and 2005 with a total sample of 14,000 female
patients admitted with heart failure. Findings from each of these studies conclude that women with heart
failure given beta blockers on discharge were less likely to be readmitted within two years.‖
Address any systematic errors found in the evidence (internal validity) such as sampling bias, treatment
bias, attrition bias, or measurement error. Keep in mind your innovative solution to a practice problem or
issue. Your evaluation of the evidence must focus on insuring patient safety and successful advancement
of practice.
Discussion
Restate your proposed solution to the problem and discuss how the body of evidence supports your
proposed innovative solution. Are there any gaps or disagreements in the evidence? On occasion you may
find the BNE or professional organizations make recommendations that are contrary to current research
evidence as evidence-based practice is a relatively new approach to practice.
How do you weigh differences in evidence? Consider the evidence in relation to the magnitude of
change your innovative solution requires. You may need to weigh the evidence against the population in
which you want to implement change where the evidence has been very good in other populations but
untested in your population of interest.
Conclusions
You should conclude with practice, research and/or policy recommendations for your innovative solution
based on your evaluation of the current evidence. Be specific. These recommendations are the
opportunities you take with you from TCU as a new CNS wanting to affect change by improving patient care
and advancing practice.
Examples: You might briefly describe practice recommendations to include staff education, physician
order set, and publication. Suggest appropriate publications. If you recommend further research, briefly
describe what should be studied and how. If policy change is in order, what is the appropriate body to
address the solution, who would you contact, and how would the policy change be transacted?
81
References
Important Notes
1. You want to use future tense in writing the proposal describing what the student will do. However, you
will want to use past tense in the literature review (because it has already been done).
2. The final paper should be written in past tense.
3. APA format, using the most recent edition of the Publication Manual of the American Psychological
Association, should be used consistently for margins, text citations, double-spacing, font size, and
references page.
4. Section headings are used for each section of the paper.
5. Each section should have an introductory or transition sentence/short paragraph describing what you
will be discussing in that section of the paper. .
6. Grammar, punctuation, and word usage should be appropriate.
7. Before submission for evaluation spell checked and proofread carefully.
ONLINE PROGRAM INFORMATION
Orientation
There is a 1-day mandatory on campus orientation prior to beginning the online program. It is scheduled in
early May on a Friday.
Computer Skills Needed for the Program
Word Processing
Email
Internet
Programs
Cut, copy, and paste text.
Use basic word processing programs.
Save and move documents and files.
Save files in different file formats (.doc .rft .xls)
Send and receive messages
Send email attachments.
Open email attachments.
Organize email files and messages.
Maneuver with your browser: back, forward, links, scroll bars, refresh, bookmarks.
Locate URLs (internet addresses).
Differentiate between the Internet and the World Wide Web.
Search for information with search engines.
Word
Excel
Powerpoint
eCollege Links
What are the computer / technical requirements for eCollege?
http://www.tcuglobal.edu/index.learn?action=technical
Is online learning for me?
http://www.tcuglobal.edu/index.learn?action=quiz
What is a course like?
http://www.tcuglobal.edu/demo40/
82
TCU Help Desk Link
http://www.helpdesk.tcu.edu/
GRADUATE NURISNG PROGRAM POLICIES
Admission Policy
Admission is competitive and an individualized approach is used to identify applicants with demonstrated
academic achievement and potential, who have strong motivation to succeed in academic study and
professional practice, and the potential to function as a leader in advanced practice and health care delivery
or nursing education. The applicant's grade point average, performance on standardized exams, writing
and speaking skills, and prior professional experience are used to assess applicants for admission. A
profile of each applicant is developed based on an admission portfolio consisting of:
 Evidence of current unencumbered licensure in the state of Texas or the state in which practicum
course work will occur.
 Evidence of current health care provider CPR, liability insurance.
 Two official transcripts from all colleges or universities attended with a preferred cumulative grade point
average of 3.0 (on a 4 point scale) earned in the basic nursing program.
 An acceptable score on the Graduate Record Examination (GRE) or the Miller Analogy Test (MAT).
 A preferred work history (resume) that includes two years of full-time experience or its equivalent as a
registered nurse. For those entering the CNS major, this experience should be in adult health, medicalsurgical units or other areas where adults receive care.
 For applicants for whom English is a second language, demonstrated English language proficiency is
measured by an acceptable score on the Test of Spoken English as a Foreign Language (TOEFL) and
the institutional version of the Test of Spoken English (TSE).
 Three letters of reference, of which two are from health care professionals and the third is preferably
from an instructor in the basic nursing program.
 A two page essay that addresses:
* Why you wish to attend graduate school.
* Why you wish to attend this program.
* Your level of computer proficiency.
Progression Policy
Graduate students are expected to meet the academic standards required by the university and found in
the TCU Graduate Bulletin. Graduate students must achieve a semester and cumulative GPA of at least
3.00, indicating the minimum acceptable letter grade of B. Regardless of overall GPA, any student
receiving a C grade in any course will be placed on academic probation for the next semester. By the end
of the probationary semester, the student must meet both semester and cumulative minimum GPA.
Students on academic probation are not eligible for registration in independent study courses. A grade
below C (D, F, or NC) is considered a failure. Any student receiving two C grades during the program is in
jeopardy of being dismissed. A student who is placed on academic probation for one semester will be
dismissed if the semester or cumulative GPA falls below a 3.00 in any subsequent semester.
A student may receive grade of F or be administratively withdrawn from a course for lack of academic
progress in the course, for unprofessional or unsafe conduct, or for receiving disciplinary action from the
Board of Nurse Examiners. The student may further be dismissed, suspended, or expelled from the
University. Recommendation for such action originates with the supervising faculty member and requires
approval of the Dean. Grades of F or Q designations will be recorded for courses in progress at the time
the student is dismissed, suspended, or expelled.
83
Program Interruptions for Life Events Policy
Unexpected life events occasionally result in the need for graduate nursing students to drop from full time
status to part time status or to miss a semester or semesters. Life events can be:
1. Individual – examples include: personal illness or injury; job loss or change; and pregnancy.
2. Family-related – examples include: illness, injury, or death of a family member; marriage;
separation/divorce; issues with children; and unexpected relocation.
3. Environmental – examples include: natural disasters like hurricanes, tornadoes, fire, and flooding.
The graduate student experiencing such an event will contact the Director of Graduate Studies.
Together, the student and director will draft an altered plan of study. If the student requires a semester or
semesters off, the student and director will mutually agree on the date of the student’s return to the
program.
If the student follows the mutually agreed upon plan or renegotiates for an alternate plan, the student
will be considered a continuing student in the program. If the student does not follow the plan, the student
will be dropped from the program and will have to reapply for readmission.
Residency Policy
Residency requirement—Online students do not have to meet the residency requirement required for oncampus students.
Transfer Credit Policy
Graduate credit earned from another accredited college or university will be considered for transfer to the
nursing master’s program, if courses have been taken within the past five years. Written request for
transfer credit with two copies of official academic transcripts reflecting the requested credit should be
made at the time of application for admission. Such credit must be applicable to the student’s program as
determined by his or her adviser, carry at least a ―B‖ grade, and be coursework taken through an accredited
school of nursing. Six semester hours of transfer credit usually is all that will be accepted, but under special
circumstances additional hours may be considered.
Graduation Related Policies
Petition for Candidacy
The Dean’s office will prepare a petition to candidacy for the master’s degree after 9 or more hours of
course work have been completed, and after all conditions to admission have been met, including the GRE
or Miller Analogy Test. The student does not need to make a formal request for candidacy. Registration for
the Professional Project will be accepted when all requirements for candidacy have been fulfilled. Until that
time the student is not considered a candidate for a degree.
Intent to Graduate
At the beginning of the semester in which the student plans to graduate, he/she must complete and return
an Intent to Graduate form. In the event that graduation cannot be completed, a cancellation form must be
filed in with the Dean. An Intent to Graduate form must be refiled in case of postponement. A nonrefundable graduation fee, which includes all graduation costs, is charged when the Intent to Graduate form
is filed.
Professional Project Preparation
A Professional Project will be completed. During the course of study, students are required to register for at
least three total hours for the Professional Project in one or more hour blocks. In order to work with his/her
committee, the student must be registered for the project. Students must be registered for at least one hour
of professional project in the semester they graduate.
The Professional Project Committee must approve the project subject. The student should frequently
consult with the chair in the progress of the project so that proper guidance may be given. The committee
will convene for the approval of the project proposal prior to initiating the project. The committee will
convene again for the final project defense at the completion of the project.
84
The student is expected to select a doctorally-prepared chair and two other members of his/her
Professional Project Committee. It is recommended that at least one other member must be doctorally
prepared. All regular and adjunct faculty members are eligible to serve on the committee. One member
may be a community expert who is at least Master’s prepared in the area of specialty and holds associate
graduate faculty status.
Comprehensive Examination
Harris College-Nursing graduate students must satisfactorily complete a comprehensive examination
before graduation. Questions for the exam will be provided by and graded by the student’s professional
project committee. Students must show satisfactory completion of all courses in the degree program,
except those in progress, before the exam may be given. Only one re-examination on a failed written
examination will be permitted. Students failing the examination twice will not receive their degree.
Summer Completion of the Degree
Students planning to complete the Professional Project and/or the comprehensive written examination
during the summer should check with the professional project committee members prior to the end of the
spring semester to affirm that their schedules will make them available during that time period.
Time Limit
The graduate student is expected to complete work, including the Professional Project, within a period of
five years from the date of beginning the graduate program. Extension of time must be applied for in writing
through the Director of HSN who will then make a recommendation to the Dean. The letter should explain
why the degree was not completed within the time limit and should present a schedule for completing the
program.
Academic Conduct Policy and Grievance Procedure
Harris College-Nursing graduate students are held to the standards of honor and integrity
described in the TCU Graduate Bulletin. This policy defines misconduct, outlines procedures for
dealing with misconduct, and identifies sanctions. Harris College-Nursing graduate students are
further expected to demonstrate the professional standards of registered nurses.
A grievance or grade appeal may be presented by an HSN graduate student by following the
informal or formal procedures defined by the University. Informal procedures are encouraged in
order to resolve grievances as promptly as possible. Formal procedures may be followed when
resolution is not achieved informally. Procedures related to grievance can be found in the TCU
Student Handbook.
Policy on Program Administrative Oversight
The Director of Harris College-Nursing and the Director of Graduate Studies in Nursing will have the
responsibility to oversee the graduate program. The Graduate Studies Committee:
 Oversees implementation of the graduate program
 Addresses admission and progression issues in the graduate program
 Develops the graduate curriculum with input from HSN faculty with Graduate Faculty Appointment.
 Monitors and performs formative evaluation of the graduate program curriculum
 Assures that the graduate program meets BNE and CCNE requirements
 Coordinates integration of any expansion to the graduate program.
Nursing Faculty with Graduate Faculty Appointment will have general oversight and approval of the
Graduate Program curriculum. Approved graduate curriculum changes will be presented to the nursing
faculty for nursing program approval, the HCNHS curriculum committee approval, and finally University
Graduate Council for approval.
The Nursing Program Effectiveness committee will oversee graduate program evaluation.
85
Drug Testing Policy (effective summer 2006)
Drug testing and criminal background checking of graduate nursing students prior to beginning clinical
courses is required by the TCU, Harris College-Nursing. Testing meets the requirements of the November
2000 Community Standards for Drug Testing and Background Screening developed by a task force of
members of the Dallas-Fort Worth Hospital Council [―Community Standards‖]. According to the Community
Standards, the rationale for the drug testing and criminal background checking is due diligence and
competency assessment of graduate students whose assignments bring them in contact with patients or
employees. Before a graduate nursing student can be placed by Harris College-Nursing at a facility for
his/her clinical experience, the graduate student must have certain acceptable results on both a drug test
and a criminal background check. Therefore, Harris College-Nursing requires drug testing and criminal
background checking of all graduate students in its nursing program as explained below.
Harris College-Nursing’s Selection of Company to Perform Drug Testing/Criminal Background
Check
Harris College-Nursing will notify graduate students of the company designated by Harris College-Nursing
to perform the drug testing and criminal background check. Harris College-Nursing will not accept drug test
and criminal background check results from any company other than the one designated by Harris CollegeNursing. Harris College-Nursing will only accept results from the designated company for drug tests and
criminal background checks provided for under this policy. For example, Harris College-Nursing will not
accept a drug test/criminal background check which a graduate student has independently obtained from
the company outside the procedure provided in this policy.
The company selected is independent and separate from both TCU and Harris College-Nursing. It is
not and shall not be considered a partner, joint venturer, employee, or agent of TCU or Harris CollegeNursing. TCU shall not be considered a partner, joint venturer, employee, or agent of the company.
At the time of the drug testing/criminal background check, the graduate student is required to pay the
cost.
Drug Testing
A. Harris College-Nursing Graduate Students Required to Drug Test/Timing of Drug Test
Harris College-Nursing graduate students enrolled in clinical coursework for the first time or a graduate
student who has had a break in enrollment in clinical courses are required to complete the drug test
prior to the first clinical day in the facility. A break in enrollment is defined as non-enrollment for one full
semester or more in clinical coursework.
B. Drug Test Procedure/Requirements
The name of the company Harris College-Nursing selects to perform the urine drug tests will be sent to
each graduate student during the semester prior to the beginning of clinical coursework. Each graduate
student shall cooperate in all aspects the urine drug test and complete the drug test at the designated
site close to his/her home. Each graduate student is required to sign any and all consents/releases, in
the form(s) designated by Harris College-Nursing, including consent to the drug test and permission for
the results of the drug test to be provided to TCU and Harris College-Nursing. It is a violation of this
policy for a graduate student to adulterate or attempt to adulterate a specimen, to engage in any
deceptive behavior during or in connection with the testing process, or take any other action which
would falsify test results or tend to make test results inaccurate.
As part of the drug testing procedure, the graduate student may be contacted by the Medical
Review Officer [―MRO‖] affiliated with the testing company. The graduate student should cooperate with
and accurately respond to inquiries of the Medical Review Officer.
A positive drug screen for a graduate student is defined under this policy to be one reported as such
by the testing company selected by Harris College-Nursing. Generally, under the Community
Standards, this refers to the testing company indicating the graduate student tested on both the
company’s initial test and GC/MS confirm test as outside the acceptable range set by the testing
company, and with the MRO not determining the test result should be a negative. A negative test for a
graduate student is defined under this policy a test result which is not a positive test result.
86
C. Reporting of Drug Test Results to Harris College-Nursing
The testing company will communicate the drug test results to the Director of Harris College-Nursing. It
is the policy of TCU and Harris College-Nursing to maintain the confidentiality of these drug test results
to the extent required by law.
D. Consequences
When a positive drug screen occurs, the following will occur:
 the graduate student will be immediately suspended for a minimum of one year (12 continuous
months from the date of the beginning of the suspension) from the nursing program; and
 the positive drug screen will be shared by Harris College-Nursing with the TCU Dean of Campus
Life for further action, including but not limited to referral for a drug abuse education program,
referral to counseling, and/or referral to a drug treatment program, under TCU’s institutional policies;
and
 the graduate student’s positive results will be reported to the Board of Nurse Examiners in the state
where he/she lives; and
 other appropriate action, if any.
Any graduate nursing student with a positive drug screen is encouraged to seek treatment.
TCU, Harris College-Nursing encourages impaired graduate students to seek assistance voluntarily
through their Boards of Nurse Examiners and assume responsibility for their personal and professional
conduct.
A graduate student who has on one occasion had a positive drug screen under this policy, and who
desires to be readmitted to TCU, Harris College-Nursing’s graduate nursing program, may reapply after
the period of suspension (one year minimum). The graduate student will, in addition to meeting all other
requirements for similarly situated applicants, be required to provide documentation of successful
treatment and proof of an unencumbered nursing license from the state where the graduate student
lives. The graduate student will be required to consent to and undergo a retest, at a time and through a
testing company selected by Harris College-Nursing, with this retest resulting in a negative drug screen.
This re-testing is at the graduate student’s expense. The decision on whether to re-admit the graduate
student is not guaranteed, and will be made on a case-by-case basis.
E. Estimated Cost of Drug Test
Cost is approximately $40.00. The cost of the drug screen is the graduate student’s responsibility.
F. Suspicion Testing Under the Community Standards
Additionally, the Community Standards provide that a graduate student assigned to a facility for a
clinical experience, and who is suspected by the facility or faculty of substance use or abuse, will be
asked to consent to a drug test, plus other consequences. In this situation, the graduate student is
required to sign the consent and complete an immediate drug test as provided by the Community
Standards.
Policy for Criminal Background Check (effective summer 2006)
A. Harris College-Nursing Graduate Students required to have Criminal Background Check/Timing of
criminal background check
Nursing graduate students enrolled in clinical coursework for the first time or a graduate student who
has had a break in enrollment in clinical courses will be required to complete the criminal background
check prior to the first clinical day. A break in enrollment is defined as non-enrollment for one full
semester or more in clinical coursework.
B. Criminal Background Check Procedure/Requirements
Each graduate student who will be the subject of the criminal background check is required to
cooperate with the company conducting the check so that it can be completed at the time required by
Harris College-Nursing prior to the graduate student contacting patients or employees at the clinical
facility. Each graduate student is required to provide the screening company accurate identifying
information requested so that the company can carry out the screen upon the graduate student. Each
graduate student is required to sign any and all consents/releases, in the form(s) designated by Harris
College-Nursing, including consent to the criminal background check and permission for it to be
provided by the company to TCU and Harris College-Nursing. It is intended that the background check
include all cities and counties of known residence for the 7-year period prior to the check.
87
Under this policy, the term ―failing‖ the criminal background check is defined as the screening
company reporting to Harris College-Nursing that the graduate student had any of the following, during
the seven year period prior to the check:
 A felony conviction.
 A misdemeanor conviction or felony deferred adjudication involving a crime against a person
(physical or sexual abuse).
 A misdemeanor conviction related to moral turpitude (prostitution, public lewdness/exposure, etc).
 A felony deferred adjudication for the sale, possession, distribution, or transfer of narcotics or
controlled substances.
 Registration as a sex offender.
 Revocation of a nursing license.
C. Reporting of Criminal Background Check to Harris College-Nursing
The company conducting the criminal background check will communicate the criminal background
check results to the Director of Harris College-Nursing. It is the policy of TCU and Harris CollegeNursing to maintain the confidentiality of these criminal background check results to the extent required
by law.
D. Consequences
When a graduate student fails the criminal background check, the following will occur:
1. The graduate student will be immediately suspended from the nursing program until the earlier of
the following: (a) the company conducting the check reports to Harris College-Nursing (perhaps
through clarifying information provided by the graduate student to the company) that the graduate
student no longer fails the check, or (2) the graduate student obtains from the Board of Nurse
Examiners of the state where he/she lives a Declaratory Order or similar decision stating the
individual is eligible for licensure or licensure renewal.
2. The graduate student will be notified of a description of the adverse action taken, the name of the
company which prepared the report, a statement that the company did not make the decision to
take the adverse action, that the graduate student has a right to obtain a free copy of the company’s
report from the company, and to contest its contents.
3. The results will be shared by Harris College-Nursing with the TCU Dean of Campus Life for further
action under TCU’s institutional policies.
4. The Board of Nurse Examiners in the state where the graduate student is licensed will be notified of
the result.
5. Other appropriate action, if any.
A graduate student who is convicted of or receives deferred adjudication for any of the criminal
offenses referred to in Section B above while enrolled in the program must report the conviction to the
Director of Harris College-Nursing, within three days of the conviction, and the graduate student will be
referred to the TCU Dean of Campus Life and suspended from the nursing program until the graduate
student obtains from the Board of Nurse Examiners in the state where he/she lives a Declaratory Order
or similar decision stating the individual is eligible for licensure or licensure renewal.
E. Estimated Cost of the Criminal Background Check
Cost is approximately $40.00. The cost of the criminal background check is the graduate student’s
responsibility.
88
TCU’s Institutional Policies/policies of Other Departments or Programs
TCU has separate and additional Institutional policies which may provide additional requirements,
disciplinary action, and/or consequences applicable to events and occurrences covered by the Harris
College-Nursing policy.
In addition, some other programs or departments at TCU have, or in the future may have, drug test
and/or criminal background check policies or procedures. These other policies and procedures, and their
terms, conditions, requirements, disciplinary action and/or consequences are in addition to those in this
Harris College-Nursing policy.
See also the TCU Graduate Student Handbook, which provides additional information about on-campus
services and health risks associated with drug and alcohol abuse.
Policy for Faculty Publishing with Students
Graduate students should be encouraged to publish their projects. Original work done by students on their
professional projects remains their work. Committee members provide suggestions for revision and editing
of the project as part of the faculty role. As a general rule, faculty should not be included as authors on any
publications of original student work. There are a limited number of circumstances where faculty members
should be included as authors on students’ manuscripts:
1. The student conducts the professional project as part of the faculty member’s research project.
2. The student does secondary data analysis of data collected by a faculty member for the professional
project.
If other situations arise where a faculty member believes he/she should be included as an author on
student publications, the student and faculty member must petition the Graduate Studies Committee for an
exemption to the policy.
Tuition Discount Policy
Graduate students may receive tuition reductions one time only for each course. Students, who drop or
withdraw from a course or courses, may re-enroll as a later date but must pay full tuition and fees for the
dropped course(s). Those students may then progress in the program and receive tuition reductions for
subsequent courses.
Policy for Qualifications, Selection, Orientation, and Evaluation of Clinical Agencies and Preceptors
Clinical preceptors are crucial to graduate nursing education providing not only daily supervision and
guidance, but also offering a rich variety of practice experience to students. As such, HSN values these
individuals and supports their inclusion in student achievement. In general, preceptors are identified by
students, faculty, or alumni. Following a review of qualifications, i.e., the ability of preceptor to demonstrate
dimensions of the CNS role, the graduate faculty and Director of Graduate Studies select and provide an
orientation for the preceptor. Students’ progress will be monitored by faculty visits, conferences, and online
discussions.
Overview and Definitions
These guidelines are applicable to nursing courses that utilize clinical preceptors to enhance learning
experiences and to assist in the supervision of students.
Clinical preceptor – A professional who works with a student to enhance student learning experiences,
provides assistance to faculty in the supervision of students, and has expertise in the advanced area of
nursing, or related field, for the course or specific learning experience.
Agency – A facility or organization focused on health care delivery (direct and indirect) including community
based and acute care institutions.
Agency Selection and Responsibilities
Clinical preceptors are used when a current Clinical Experience Agreement exists between HSN and the
agency where the student experience is planned. The faculty member assigned to the course is responsible
for communicating with the Clinical Facilities Coordinator to ensure that the Clinical Experience Agreement
89
is current. This information is maintained by HSN Facilities Coordinator and is located in the HSN
Administrative Offices.
The agency/facility retains ultimate responsibility for care of clients and responsibility for the preceptor’s
salary, benefits and liability. The agency/facility assists faculty members in identifying and communicating
with qualified and responsible individuals who may want to serve in this role.
Criteria for Selection of Clinical Facilities for Graduate Students
1. Personnel-Student Interaction:
A. Opportunities are available for the student to interact as a member of the interdisciplinary health
care team using advanced practice nursing knowledge and skills.
B. Preceptor(s) are available and have agreed to help students find appropriate advanced practice
nursing learning opportunities.
C. Clinical facility personnel are open and receptive to students.
D. Opportunities are available for students and clinical facility personnel to critique one another.
2. Preceptors:
A. Base Practice on current knowledge, theory and research.
B. Assess and manage physical and psychological symptoms.
C. Advocate for patients within the health care delivery system.
D. Incorporate nursing standards and accountability into practice.
E. Meet the requirements of the preceptor contract.
3. Environmental Support for Learning
A. The philosophy of the agency is congruent with the
philosophy of Harris School of Nursing.
B. Students receive a facility orientation.
C. A place for students’ personal belongings is available.
D. Students have access to conference or seminar rooms.
E. Students have access to necessary equipment, supplies, and patient and institutional data.
F. There is an adequate client population to meet the course objectives.
G. The clinical environment promotes a positive learning experience.
4. Overall Evaluation
A. Opportunities exist for students to meet learning objectives.
B. Students recommend continued use of the facility.
Procedures for Coordinating Clinical Facilities for the Graduate Program
Maintain current Clinical Experience Agreements with all agencies in which HSN graduate students have
clinical experiences. Establish and maintain effective communication between HSN and clinical agencies.
Establish and maintain effective communication with HSN faculty regarding clinical agencies. Maintain
system for evaluating appropriateness of clinical facilities using the Clinical Agency Evaluation Process.
Clinical Agency Evaluation Process for the Graduate Program
Goal
To ensure that the size, type, and variety of clinical sites are adequate to meet program goals.
Rationale
1. Quantitative and qualitative data allow comparison of student and faculty perceptions.
2. Facilitates identification of strengths and limitations of agencies being used.
3. Forms basis for decisions about continuing use of agency, modifications/problem solving about use of
agency, or discontinuation of use of agency.
4. Participation of the Clinical Facilities Director (CFD) with a four-school Clinical Coordinators Council
(CCC) facilitates shared clinical placement process, ongoing assessment of shared agencies, and
maintains communication among schools and agencies in the Fort Worth area.
90
Methods
1. CFD will provide oversight of the clinical facilities review process for the School.
2. The CFD will coordinate with the Director of Graduate Studies to develop, revise, or maintain agency
affiliations.
Assessment Data
1. Quantitative and qualitative assessment of facilities by faculty and students, using Student/ Faculty
Evaluation of Clinical Facility.
a. Each student will rate each clinical facility in which they had CNS practicum experience.
b. Annually, each of the clinical faculty will rate each clinical facility used each semester.
2. Visits to agencies by CFC and/or graduate faculty may occur
3. Faculty ongoing assessment of agencies during practicum.
4. CFD activities with the CCC.
Time/Frequency of Assessment
Each semester:
Annually:
Every 3 years:
As needed:
Student Evaluation of Clinical Facility
Ongoing evaluation by CFC and Faculty
Faculty Evaluation of Clinical Facility
Review of each agency contract
When change necessitated by changing facility status, changing
census, patient availability, change in agency or program/course
objectives, and negative evaluation by faculty or students
Communication/Actions Related to Evaluation Results
1. Reports from CCC and agency evaluations given to appropriate faculty, the Director of Graduate
Studies, and Program Effectiveness Committee.
2. CFD and the Director of Graduate Studies, in consultation with the HSN Director, will make decisions
for continuation, modification, or discontinuation based on evaluation results and School needs.
3. In report each semester to clinical facility, the Director of Graduate Studies communicates results to
student and faculty evaluations, celebrating areas with positive evaluations and problem-solving areas
with concerns.
Preceptor Selection and Responsibilities
The faculty member assigned to the respective course is responsible for securing clinical preceptors and
submitting to Harris College-Nursing’s administrative office a completed Clinical-Preceptor Agreement.
These blank agreements may be obtained in the HSN Office.
Criteria
Criteria for the selection of clinical preceptors should include the following:
1. Current Licensure as a registered nurse in the state where the precepting will occur; or if not a
registered nurse, a current license as a health care professional in the state where the precepting will
occur and an appropriate degree in that field of expertise.
2. Substantial experience in nursing, or their field, with a least two years experience in the area in which
the student experience is planned.
3. Certification and/or BNE approval as a CNS for supervision of CNS clinical courses.
4. Recommendation by the potential preceptor’s immediate supervisor or a faculty member of HSN.
5. A philosophy of health care delivery and nursing which is congruent with HSN.
Preceptor Responsibilities
Preceptor responsibilities include:
1. Participating in a meeting about the course with faculty member.
2. Completing the online preceptor orientation course.
3. Functioning as a role model in the clinical setting.
4. Orienting the student to the facility.
91
5. Guiding and supervising the student in achieving clinical objectives; this includes supervision of student
performance of skills and other nursing activities to facilitate safe practice.
6. Arranging for appropriate coverage by an approved preceptor for supervision of student should
preceptor be absent.
7. Providing significant input about, evaluating and grading student performance.
8. Providing feedback about the preceptor experience to faculty and students.
9. Contacting faculty if assistance is needed or if any problems/issues with student performance occur.
10. Updating changes in the biographical profile for the nursing education program using the Clinical
Preceptor Biographical Data form.
11. Assuring student compliance with agency policies and procedures.
Faculty Responsibilities
The faculty member is responsible for:
1. Ensuring that current and complete Clinical-Preceptor Agreements are filed with the HSN Office no later
than the third week of the planned experience.
2. Providing a list of each preceptor being utilized, their contact information (work number, pager number if
appropriate, work address) and the name of each preceptor’s assigned student and the students
contact number to HSN Office and HSN Facilities Coordinator no later than the third week of the
planned experience.
3. Orienting both the student and preceptor to the preceptored experience.
a. Preceptor: Prior to the experience, provide the preceptor with an orientation to the course
objectives, and student background and previous learning and skills (what courses the student has
completed; what skill the student has demonstrated; student guidelines for performance of
procedures; student limitations in performance.
b. Student: Document that student is in compliance with standards on immunizations (TB, MMR
tetanus), CPR, knowledge of OSHA standards and has appropriate liability insurance coverage.
4. Working cooperatively with the preceptor and agency to determine student learning needs and
assignments.
5. Assigning individual students with preceptors and communicating assignments and other essential
information to agencies.
6. Communicating regularly with the preceptor and the student in order to facilitate, monitor, and evaluate
the learning experience.
7. Monitoring student progress through regularly scheduled conferences, onsite visitation, and review of
written work.
8. Being readily available by telephone and pager for ongoing consultation when students are in the
clinical area.
9. Receiving feedback from the preceptor regarding student performance.
Student Responsibilities
1. Maintaining open communication with the preceptor and faculty.
2. Selecting assignments/learning experiences consistent with clinical objectives with assistance from
preceptor.
3. Preparing for each clinical experience by reading and practicing needed skills.
4. Documenting achievement of clinical objectives as outlined in course syllabus and sharing in online
seminars when appropriate.
5. Arranging for preceptor’s supervision when needed.
6. Contact faculty by telephone or pager when faculty assistance is needed.
7. Notifying both faculty and clinical preceptor if there will be absence/tardiness from the clinical
experience.
8. Making arrangements with clinical preceptor and instructor to reschedule missed clinical experiences.
9. Evaluating the clinical experience and preceptor.
10. Following all policies of the agency and the nursing educational program.
11. Assuming responsibility for own actions.
12. Maintaining current immunization status.
92
13. Maintaining current CPR status
Process for Preceptor Evaluation
Upon completion of the preceptored experience, the student and the assigned faculty member will each
complete a Preceptor Evaluation Form, which will be submitted by the faculty to the HSN Office for filing
with each individual preceptor’s agreement. Evaluations of preceptors will be retained for 4 years.
Supervision of Graduate Students
The purpose of graduate student supervision is to promote, encourage, and facilitate practice learning in a
safe environment. Recognizing that online methods may create distance between faculty and students,
frequent faculty, preceptor and student communication becomes imperative and integral. The following
guidelines describe appropriate clinical supervision:
 Graduate students have experience as Registered Nurses. Their clinical experiences are designed to
teach them advanced concepts appropriate for the advanced practice role.
 Faculty, students, and preceptors engage in an open, participative relationship to facilitate learning.
Clear expectations about learning and supervisory roles are communicated at the beginning and
throughout each course. Policy and agency parameters are clearly identified. Course grade is assigned
by the faculty with significant input from the preceptor and the student.
 The normal progression of student development results in increasing independence. This does not
mean that the preceptor or faculty member is unavailable; rather, their roles move from active guides
and models toward coaches and finally observer
93
CNS AND EDUCATOR PROGRAMS’ FULL TIME COURSES OF STUDY
SEMESTER
BSN COHORT (IN CNS AND EDUCATOR TRACKS)
+ POST MASTER’S CERTIFICATE
1st Year May Minimester
CNS Students only
NURS 50022- Advanced Practice Roles
1st Summer
Both BSN-MSN Tracks:
NURS 60443 – Financial Concepts in Health Care
NURS 60013 – Health Policy Law Ethics
1st Fall
Both BSN-MSN Tracks:
NURS 50003 – Advanced Pathophysiology
NURS 60043 – Advanced Nursing Research & Theory
1st Spring
Both BSN-MSN Tracks:
NURS 50053 – Advanced Pharmacotherapeutics
NURS 50013 – Advanced Health Assessment
2nd Summer
Both BSN-MSN Tracks:
NURS 60414 – Adult/Gero Nursing Concepts OR
NURS 60744 – Parent/Child Nursing Concepts
NURS 60482 – Combined Practicum
2nd Fall
CNS Students
NURS 60513 – CNS II
NURS 60583 – CNS II Practicum
NURS 60030 – Professional Project
Educator Students
NUED 60713- Learning & Instruction
NUED 60723 – Curriculum & Program Development
NURS 60030 – Professional Project
Post Master’s Certificate Students
NUED 60713- Learning & Instruction
NUED 60723 – Curriculum & Program Development
2nd Spring
CNS Students
NURS 60613 – CNS III
NURS 60683 – CNS III Practicum
NURS 60030 – Professional Project
Educator Students
NUED 60733 – Evaluation in Nursing Education
NUED 60783 – Teaching Practicum
NURS 60030 – Professional Project
Post Master’s Certificate Students
NUED 60733 – Evaluation in Nursing Education
NUED 60783 – Teaching Practicum
94
95
CNS AND EDUCATOR PROGRAMS’ PART TIME COURSES OF STUDY
SEMESTER
BSN COHORT (IN CNS AND EDUCATOR TRACKS)
+ POST MASTER’S CERTIFICATE
1st Year May Minimester
CNS Students only
NURS 50022- Advanced Practice Roles
1st Summer
Both BSN-MSN Tracks:
NURS 60443 – Financial Concepts in Health Care
1st Fall
Both BSN-MSN Tracks:
NURS 50003 – Advanced Pathophysiology
1st Spring
Both BSN-MSN Tracks:
NURS 50053 – Advanced Pharmacotherapeutics
2nd Summer
Both BSN-MSN Tracks:
NURS 60013 – Health Policy Law Ethics
2nd Fall
Both BSN-MSN Tracks:
NURS 60043 – Advanced Nursing Research & Theory
2nd Spring
Both BSN-MSN Tracks:
NURS 50013 – Advanced Health Assessment
3rd Summer
Both BSN-MSN Tracks:
NURS 60414 – Adult/Gero Nursing Concepts OR
NURS 60744 – Parent/Child Nursing Concepts
NURS 60482 – Combined Practicum
3rd Fall
CNS Students
NURS 60513 – CNS II
NURS 60583 – CNS II Practicum
NURS 60030 – Professional Project
Educator Students
NUED 60713- Learning & Instruction
3rd Spring
CNS Students
NURS 60613 – CNS III
NURS 60683 – CNS III Practicum
NURS 60030 – Professional Project
Educator Students
NUED 60733 – Evaluation in Nursing Education
4th Fall
Educator Students
96
SEMESTER
BSN COHORT (IN CNS AND EDUCATOR TRACKS)
+ POST MASTER’S CERTIFICATE
NUED 60723 – Curriculum & Program Development
NURS 60030 – Professional Project
4th Spring
Educator Students
NUED 60783 – Teaching Practicum
NURS 60030 – Professional Project
97
Board of Nurse Examiners for the State of Texas (BNE) Rules and Regulations
Applicable to the Graduate Program
Board of Nurse Examiners for the State of Texas
Rules and Regulations
CHAPTER 219. ADVANCED NURSE PRACTITIONER PROGRAM
§219.1. General Requirements
(a) General Requirements. Advanced educational programs in the State of Texas shall
be accredited by the Board or by a national accrediting body recognized by the Board.
(1) An educational institution located in Texas may apply for Board accreditation for
advanced educational programs that prepare either nurse practitioners or clinical
nurse specialists. Only that portion of the program of study that qualifies registered
nurses for authorization to practice in an advanced role and specialty recognized by
the Board is eligible for accreditation.
(2) To be eligible to apply for state accreditation, the advanced educational program
must be at a post-basic nursing education level.
(3) All new advanced educational programs must be at the graduate or postgraduate level.
(b) These standards have been developed for use by nurse practitioner and clinical
nurse specialist programs accredited by or seeking accreditation by the Board. The
purpose of these standards is:
(1) To promote safe and effective advanced nursing practice,
(2) To serve as a guide for development of new advanced educational programs that
prepare nurse practitioners and clinical nurse specialists,
(3) To provide criteria for the evaluation of new and established advanced
educational programs that prepare nurse practitioners and clinical nurse specialists,
and
(4) To foster continued improvement of established advanced educational programs.
The provisions of this §219.1 adopted to be effective September 13, 2001, 26 TexReg 6889.
§219.2. Definitions
The following words and terms, when used in this chapter, shall have the following
meanings unless the context clearly indicates otherwise:
(1) Accredited program—A program that has been determined to have met the
standards set by the Board or by a national accrediting body recognized by the
Board.
(2) Advanced educational program—A post-basic advanced practice nurse program
at the certificate or master’s degree level. Beginning January 1, 2003, a minimum of
a graduate degree in the advanced practice role and specialty will be required for
authorization as an advanced practice nurse.
(3) Advanced practice nurse—A registered nurse approved by the Board to practice
as an advanced practice nurse based on completing an advanced educational
program acceptable to the Board. The term includes a nurse practitioner, nursemidwife, nurse anesthetist, and a clinical nurse specialist. The advanced practice
nurse is prepared to practice in an expanded role to provide health care to
individuals, families, and/or groups in a variety of settings including, but not limited
to homes, hospitals, institutions, offices, industry, schools, community agencies,
98
public and private clinics, and private practice. The advanced practice nurse acts
independently and/or in collaboration with other health care professionals in the
delivery of health care services.
(4) Affiliating agency—Agencies outside the institution that are utilized in providing
learning experiences for the students.
(5) Board—The Board of Nurse Examiners for the State of Texas.
(6) Clinical learning experiences—Planned learning experiences that involve direct
contact with patients under guidance of faculty.
(7) Diagnosis and management course—A course offering both didactic and clinical
content in clinical decision-making and aspects of medical diagnosis and medical
management of diseases and conditions. Supervised clinical practice must include
the opportunity to provide pharmacological and non-pharmacological management of
diseases and problems considered within the scope of practice of the advanced
practice nurse’s specialty and role.
(8) Didactic learning experiences—Any planned learning activities that take place in
the classroom, learning resource center, skills laboratory, or similar settings under
the guidance of faculty.
(9) Director—A registered nurse responsible for the administration of the advanced
educational program and who meets the requirements as stated in §219.6(f) of this
chapter (relating to Administration and Organization).
(10) Distance education—Instruction delivered by an accredited program by any
means to any location(s) other than the main campus. Distance education may range
from offering a single course or multiple courses to offering the entire program of
study.
(11) Governing institution—A college or university responsible for the administration
and operation of the program.
(12) Party state—Any state that has entered into the Nurse Licensure Compact.
(13) Practicum—The practicum is that portion of the program consisting of clinical
experiences for the purpose of integrating theory with practice. The term includes,
but is not limited to, preceptorship, residency and integration.
(14) Qualified preceptor—An advanced practice nurse, physician or other health care
professional acceptable to the Board who meets the following requirements:
(A) Holds an active, unencumbered license (where licensure is required),
(B) Is in current practice in the advanced specialty area,
(C) Is committed to the concept of the advanced practice nurse, and
(D) Functions as a supervisor and teacher and evaluates the student’s
performance in the clinical setting.
(15) Shall and must—Mandatory requirements.
(16) Should—A recommendation.
(17) Unencumbered license—A professional license that does not have stipulations
against it.
The provisions of this §219.2 adopted to be effective September 13, 2001, 26 TexReg 6889.
99
§219.3. Program Development, Closure, and Transfer of Administrative Control
(a) New Programs.
(1) Proposal to develop an advanced educational program
(A) A college or university regionally accredited by a Board recognized
approval/accrediting body is eligible to submit a proposal to develop an
advanced educational program. Notice of intent to establish an advanced
educational program shall be submitted in writing well in advance of the
anticipated start of
the program. This process may take 12 to 18 months to complete.
(B) The proposal shall be completed under the direction/consultation of a
registered nurse who:
(i) Holds a minimum of a master’s degree in nursing or the equivalent thereof
as determined by the Board,
(ii) Is authorized to practice as an advanced practice nurse in an advanced
role and specialty appropriate to the type of program being proposed, and
(iii) Has teaching and administrative experience related to the type of
program being proposed.
(C) The proposal shall include information outlined in Board guidelines.
(D) The proposal shall include documentation of Texas Higher Education
Coordinating Board approval, as applicable.
(E) The proposal will be considered by the Board following a public hearing at a
regularly scheduled meeting of the Board. The Board may approve, defer action
on, or deny the proposal.
(2) Application for Initial Accreditation
(A) Initial accreditation must be granted prior to admission of students.
(B) Following approval to develop an advanced educational program, the director
and faculty shall develop the application for initial accreditation.
(C) The director and faculty shall plan the program of learning.
(D) The application shall include information outlined in Board guidelines.
(E) The Board shall review the application and supporting evidence at a regularly
scheduled meeting. If the program is based upon educational principles
acceptable to the Board and is in compliance with the Board’s requirements as
specified in this subsection, initial accreditation may be granted.
(F) Survey visits shall be conducted, as necessary, by Board staff until full
accreditation is granted.
(b) Transfer of Administrative Control by Governing Institutions
(1) A governing institution of an advanced educational program that has full
accreditation status may request permission from the Board to transfer administrative
control of the program or any portion thereof.
(A) A governing institution that proposes to transfer administrative control of an
advanced educational program or any portion thereof to another governing
institution accredited by a Board recognized approval/accrediting body shall
submit:
(i) Notice of intent to transfer administrative control in writing to the Board
twelve months prior to the anticipated date of transfer, and
(ii) A written plan for closure of the nursing program as required by
subsection (c) of this section if the entire program is to be transferred.
100
(B) The governing institution that will assume responsibility for the program shall
submit a Proposal to Assume Administrative Control to the Board six months
prior to a regularly scheduled Board meeting.
(i) The proposal shall be completed under the direction/ consultation of a
registered nurse who holds a minimum of a master’s degree in nursing, is
authorized to practice as an advanced practice nurse in a related advanced
role and specialty of the type of program being proposed, and who has
teaching and administrative experience related to the type of program being
proposed.
(ii) The proposal shall include information outlined in Board approved
guidelines.
(iii) The proposal shall include documentation of Texas Higher Education
Coordinating Board approval, as applicable.
(iv) The proposal will be considered by the Board at a regularly scheduled
meeting.
(v) The Board may approve, may defer action, or may deny further
consideration of the proposal.
(2) Accreditation Status of Transferred Program(s)
(A) If the governing institution that is assuming administrative control previously
has been responsible for an accredited program and does not intend to change
the program of study, then the program shall maintain its accreditation status.
(B) If the governing institution that is assuming administrative control previously
has been responsible for an accredited program and intends to alter the program
of study, then that governing institution shall submit a proposal to change the
program of study in accordance with §219.9 of this chapter.
(C) If the governing institution that is assuming administrative control has not
previously been responsible for an accredited program, then that governing
institution shall submit an application for initial accreditation in accordance with
subsection (a)(2) of this section.
(c) Closing a Program or Portion Thereof.
(1) When the decision to close a program or portion thereof has been made, the
director must notify the Board and submit a written plan for closure that includes the
following:
(A) Reason for closing the program or portion thereof;
(B) Date of intended closing;
(C) Academic provisions for students;
(D) Provisions made for access to and safe storage of vital school records,
including transcripts of all graduates; and
(E) Methods to be used to maintain requirements and standards until the
program or portion thereof closes.
(2) The program or portion thereof shall continue within standards until all classes
that are enrolled at the time of the decision to close have graduated. In the event this
is not possible, a plan must be developed whereby students may transfer to other
accredited programs.
The provisions of this §219.3 adopted to be effective September 13, 2001, 26 TexReg 6889.
101
§219.4. Accreditation
(a) The progressive designation of accreditation status is not implied by the order of the
following listing. Accreditation status is based upon each program’s performance and
demonstrated compliance to the Board’s requirements. Change from one status to
another is based on annual reports or survey visits. Types of accreditation include:
(1) Initial accreditation. Initial accreditation is written authorization to admit students
and is granted if the program meets the requirements of the Board.
(2) Full accreditation. Full accreditation is granted to an advanced educational
program after one class has completed the program and is based upon evidence that
the program is continuing to meet the Board’s legal and educational requirements.
(3) Accreditation (Initial or Full) With Warning
(A) Issuance of warning. When the Board determines that a program is not
meeting the Board’s legal and/or education requirements, the program is issued
a warning, is provided a list of the deficiencies, and is given a specified time in
which to correct the deficiencies.
(B) Failure to correct deficiencies. If the program fails to correct the deficiencies
within the prescribed period, the Board may:
(i) Restrict admissions or other program activities until the deficiencies are
corrected,
(ii) Place the program on conditional accreditation, or
(iii) Deny accreditation.
(4) Conditional Accreditation. Conditional accreditation is granted for a time specified
by the Board in order to provide additional time to correct the deficiencies.
(A) The program shall not admit students while on conditional accreditation.
(B) The Board may establish specific criteria to be met in order for the program’s
conditional accreditation status to be removed.
(C) Depending upon the degree to which the Board’s legal and educational
requirements are met, the Board may change the accreditation status to full,
warning, or deny accreditation.
(b) Denial of Accreditation. A program that fails to meet legal and educational
requirements of the Board within the specified time shall be removed from the list of
state accredited nursing programs. Reasons for denial of initial or continuing
accreditation include but are not limited to:
(1) Failure to meet specific criteria set out by the Board and
(2) Continued lack of compliance with minimum requirements as set out in this
chapter.
(c) Accreditation Procedures. The continuing accreditation status of each program shall
be determined annually by the Board based upon:
(1) Review of annual report. Each Board-accredited advanced educational program
shall submit an annual report regarding its compliance with the Board’s legal and
educational requirements. Accreditation status is determined on the basis of the
program’s annual report and other pertinent data when a program is not visited by
staff.
(2) Survey visit. Each nursing program will be visited at least every six years after full
accreditation has been granted. The Board may authorize staff to conduct a survey
visit at any time based upon established criteria.
(3) A written report of the survey visit or annual report will be reviewed by the Board
at a regularly scheduled meeting.
(4) Notice of a program’s accreditation status will be sent to the director, chief
administrative officer of the governing institution, and others as determined by the
Board.
102
(d) Voluntary Withdrawal from the Accreditation Process.
(1) An advanced educational program accredited by the Board may withdraw from
the Board accreditation process by notifying the Board of its intention to withdraw in
writing.
(2) The advanced educational program shall be removed from the list of Board
accredited nursing programs.
(3) Withdrawal of accreditation status will become effective at the end of the yearly
review period.
(4) Programs may reapply for initial accreditation at any time.
The provisions of this §219.4 adopted to be effective September 13, 2001, 26 TexReg 6889.
§219.5. Mission and Goals (Philosophy and Outcomes)
(a) The mission and goals (philosophy and outcomes) of the advanced educational
program shall be developed by the faculty.
(b) The mission and goals (philosophy and outcomes) shall be consistent with:
(1) The mission of the governing institution;
(2) The scope of practice of the advanced specialty and role;
(3) The targeted population or setting for delivery of advanced practice nursing care;
and
(4) Professional, educational, and ethical standards of nursing.
(c) The program goals or outcomes shall be consistent with the program’s mission or
philosophy and shall describe the capabilities of the graduates of the program.
(d) The written mission and goals (philosophy and outcomes) shall be used as a basis
for planning, organizing, implementing and evaluating the program and shall be shared
with the students.
(e) The faculty shall periodically review the mission and goals (philosophy and
outcomes), consider student input as appropriate, and make necessary revisions.
The provisions of this §219.5 adopted to be effective September 13, 2001, 26 TexReg 6889.
§219.6. Administration and Organization
(a) The advanced educational program shall operate within or be affiliated with a college
or university. New programs shall operate or be affiliated with colleges or universities
authorized to award graduate degrees.
(b) The governing institution shall be accredited by a Board recognized accrediting/
approval agency.
(c) There shall be adequate financial support commensurate with the financial resources
of the institution and appropriate to the needs of the program.
(d) The structural relationship between the governing institution and advanced
educational program specifies lines of responsibility and authority and channels of
communication.
(e) In colleges and universities, the program shall have comparable status with other
academic units and in areas affecting faculty such as salary, rank, promotion, tenure,
leave, benefits, academic rights, and professional development.
103
(f) Each advanced educational program shall be administered by a qualified nurse
faculty member who is accountable for the planning, implementation and evaluation of
the advanced educational program. The director shall:
(1) Hold a current, valid, unencumbered license to practice as a registered nurse in
the State of Texas or reside in any party state and hold a current, valid,
unencumbered registered nurse license in that state;
(2) Hold a minimum of a master’s degree in nursing or the equivalent thereof as
determined by the Board;
(3) Be authorized to practice as an advanced practice nurse in a role and specialty
appropriate to the type of program;
(4) Have a minimum of three years teaching experience in a program appropriately
related to the type of program being administered; and
(5) Have demonstrated knowledge, skills, and abilities in administration within
graduate level advanced educational programs.
(g) When the director of the program changes, the director shall submit to the Board
written notification of the change indicating the final date in the position.
(1) A new director qualification form shall be submitted to the Board office by the
governing institution for approval prior to appointing a new director for an existing
program or a new advanced educational program.
(2) A vitae and all official transcripts shall be submitted with the new director
qualification form.
(3) In a fully accredited program, if the individual to be appointed as director does not
meet the requirements for director as specified in subsection (f) of this section, the
administration is permitted to petition for a waiver of the Board’s requirements prior
to the appointment of said individual.
(4) An acting director may be appointed for a period of time not to exceed one year.
The provisions of this §219.6 adopted to be effective September 13, 2001, 26 TexReg 6889.
§219.7. Faculty Qualifications and Faculty Organization
(a) Faculty Qualifications.
(1) Documentation of faculty qualifications shall be included in the official files of the
program. Each nurse faculty member shall:
(A) Hold a current, valid license to practice as a registered nurse in the State of
Texas or reside in any party state and hold a current, valid registered nurse
license in that state;
(B) Hold a minimum of a master’s degree in nursing or the equivalent thereof as
determined by the Board; and
(C) Be qualified through academic preparation to teach the subject assigned and
shall meet the standards for faculty appointment by the governing institution.
(2) Faculty responsible for clinical management courses or involved in clinical
teaching and supervision shall also:
(A) Be authorized to practice as advanced practice nurses in the state in which
they practice;
(B) Have clinical practice experience at the advanced practice nursing level of at
least two years. If a faculty member has less than two years advanced practice
nursing experience, that faculty member must be responsible to a qualified
faculty member; and
(C) Maintain clinical practice within the advanced role and specialty.
104
(b) An advanced educational program shall employ sufficient faculty members with
graduate preparation and expertise necessary to enable students to meet the program
goals. The number of faculty members shall:
(1) Provide students with a level of instruction and supervision that is compatible with
safe practice and that includes educational experiences necessary to meet students’
learning needs; and
(2) Be determined by such factors as:
(A) The number and level of students enrolled;
(B) The curriculum plan;
(C) Activities and responsibilities required of faculty;
(D) The number and geographic locations of preceptors, affiliate agencies, and
clinical practice settings; and
(E) The complexity of care and acuity of patients.
(c) Faculty shall function under the same general policies that affect other faculty
members in the institution; however, variations of these policies may be necessary
because of the nature of the curriculum for which the faculty must have authority and
responsibility.
(1) Policies concerning workload for faculty and the director shall be in writing.
(2) Time shall be provided faculty to accomplish those activities related to the
teaching-learning process as well as meet other institutional duties such as scholarly
activities, practice, or research.
(3) The teaching load of the director shall not negatively impact his/her ability to
administer the program.
(d) The faculty shall be organized with written policies and procedures and/or bylaws to
guide its activities. The policies, procedures, and/or bylaws shall be consistent with the
governing institution.
(1) The faculty shall meet regularly and function in such a manner that all members
participate in planning, implementing, and evaluating the program. Such participation
includes, but is not limited to, the initiation and/or change of academic policies,
personnel policies, curriculum, utilization of affiliate agencies, and program
evaluation.
(2) Minutes of faculty organization and/or committee meetings shall document the
reasons for actions and the decisions of the faculty and shall be available for
reference.
(e) There shall be written plans for faculty orientation, development, and evaluation.
(1) Orientation of new faculty members shall be initiated at the onset of employment.
(2) A program of faculty development shall be offered to encourage and assist faculty
members to meet the program’s needs as well as individual faculty member’s
professional development needs.
(3) A variety of means shall be used to evaluate faculty performance such as self,
student, peer and administrative evaluations as well as program outcomes.
The provisions of this §219.7 adopted to be effective September 13, 2001, 26 TexReg 6889.
105
§219.8. Students
(a) Students should have a mechanism for input into the development of academic
policies and procedures, curriculum planning, and evaluation of teaching effectiveness.
(b) The number of students admitted to the program shall be determined by the number
of qualified faculty, adequate educational facilities and resources, and the availability of
appropriate clinical learning experiences for students.
(c) Written policies regarding admission and progression shall be developed and
implemented in accordance with the requirements that the governing institution must
meet to maintain accreditation. Student policies that differ from those of the governing
institution shall be in writing and shall be made available to faculty and students.
(d) Students shall hold a current, valid license or multi-state privilege to practice as a
registered nurse in the state(s) in which they participate in any clinical learning
experiences, including, but not limited to, laboratory or observational experiences.
(e) There shall be written policies for student grievance, health, safety, and welfare.
(f) Students shall have the opportunity to evaluate faculty, courses, and learning
resources and these evaluations shall be documented.
The provisions of this §219.8 adopted to be effective September 13, 2001, 26 TexReg 6889.
§219.9. Program of Study
(a) The program of study shall be:
(1) At least the equivalent of one academic year;
(2) Planned, implemented, and evaluated by the faculty;
(3) Based on the mission and goals (philosophy and outcomes);
(4) Organized logically and sequenced appropriately; and
(5) Based on educational principles acceptable to the Board.
(b) For clinical nurse specialist programs, the program of study must also qualify the
graduate for a master’s degree in nursing.
(c) The curriculum content shall include:
(1) Didactic and clinical learning experiences necessary to meet the goals or
outcomes;
(2) Concepts and principles critical to advanced practice nursing;
(3) Professional and legal implications of the nurse in the advanced role;
(4) Knowledge and skills relevant to practice in the area of specialty; and
(5) Clinical nurse specialist and nurse practitioner course requirements published by
the Texas Higher Education Coordinating Board in collaboration with the Board of
Nurse Examiners that became effective in January 1997:
(A) Separate courses in pharmacotherapeutics, advanced assessment, and
pathophysiology or psychopathology. These courses must be advanced level
academic courses with a minimum of 45 clock hours per course;
(B) Evidence of theoretical and clinical role preparation;
(C) Evidence of clinical major courses in the specialty area;
(D) Evidence of a practicum/preceptorship/internship to integrate essential
content and the clinical major courses.
(d) For clinical nurse specialist programs, the curriculum must also contain a minimum of
nine semester credit hours or the equivalent in a specific clinical major. Clinical major
courses must include didactic content and offer clinical experiences in a specific clinical
specialty/practice area.
106
(e) If a clinical nurse specialist program has as a goal or outcome the preparation of
graduates for approval for limited prescriptive authority, then the program must also
include at a minimum a separate course in diagnosis and management of problems
within the clinical specialty area. This course(s) must be an advanced level academic
course(s) with a minimum of 45 clock hours.
(f) The program of study shall include a minimum of 500 clinical hours.
(g) Post-master’s preparation may be offered as graduate level course work through
certificate or master’s level advanced educational programs that include the desired role
and specialty and otherwise meet the standards in this chapter.
(1) Post-master’s students are required to complete a minimum of 500 clinical hours
and the equivalent of all of the role, clinical major, and Texas Higher Education
Coordinating Board curricular requirements. Courses may be waived if an
individual’s transcript indicates that an equivalent course has been successfully
completed or if the student demonstrates proficiency, validating program outcomes
according to written program policies.
(2) Only registered nurses who hold master’s degrees in nursing shall be eligible for
post-master’s preparation as clinical nurse specialists.
(h) Board staff approval is required prior to implementation of major curriculum changes.
Proposed changes shall include information outlined in Board guidelines and shall be
reviewed using Board standards.
(1) Changes that require approval include:
(A) Changes in program mission and goals (philosophy and outcomes) that result
in a reorganization or reconceptualization of the entire curriculum, and/or
(B) An increase or decrease in program length by more than nine semester credit
hours or 25%.
(2) All other revisions such as editorial updates of mission and goals or redistribution
of course content or course hours shall be reported to the Board in the Annual
Report.
The provisions of this §219.9 adopted to be effective September 13, 2001, 26 TexReg 6889.
§219.10. Management of Clinical Learning Experiences and Resources
(a) Faculty shall be responsible and accountable for managing clinical learning
experiences of students.
(b) Faculty shall develop criteria for the selection of affiliate agencies or clinical practice
settings that address the need for students to observe and practice safe, effective health
care.
(c) Faculty shall select and evaluate affiliate agencies or clinical practice settings that
provide students with opportunities to achieve the goals of the program.
(d) Written agreements between the program and the affiliating agencies shall specify
the responsibility of the program to the agency and the responsibility of the agency to the
program. Such agreements shall be developed jointly with the affiliating agency,
reviewed periodically according to the policies of the program and the affiliating agency,
and include provisions for adequate notice of termination.
107
(e) When clinical preceptorships are used in an advanced educational program, the
following conditions shall be met:
(1) Written agreements between the program, clinical preceptor and the affiliating
agency, when applicable, shall delineate the functions and responsibilities of the
parties involved.
(2) Criteria for selecting clinical preceptors shall be developed in writing. Competent
clinicians can be considered qualified to be preceptors if they are:
(A) Authorized to practice as advanced practice nurses in the state in which they
practice, or
(B) A currently licensed health care professional who can provide supervision
and teaching in clinical settings appropriate for advanced practice nursing.
(3) Written clinical objectives shall be specified and shared with the clinical preceptor
prior to the experience.
(4) The designated faculty member shall be responsible for the student’s learning
experiences and shall communicate regularly with the clinical preceptor and student
for the purpose of monitoring and evaluating
learning experiences. If site visits are not feasible, communication and evaluation are
managed by alternatives such as telephone, written communications, or clinical
simulations.
(f) The maximum number of students that one advanced educational program faculty
member supervises in a clinical course should not exceed six students.
(1) If faculty are providing on-site clinical supervision of students, the ratio should not
exceed two students to one faculty member during the clinical day.
(2) If faculty are supervising students while managing their own caseload of patients,
the ratio should not exceed one student per faculty during the clinical day.
The provisions of this §219.10 adopted to be effective September 13, 2001, 26 TexReg 6889.
§219.11. Facilities, Resources, and Services
(a) The physical facilities shall be adequate to meet the needs of the program in relation
to the size of the faculty and the student body.
(b) The director shall have a private office.
(c) Faculty offices shall be conveniently located and adequate in number and size to
provide faculty with the opportunity for uninterrupted work and privacy for conferences
with students.
(d) Space for clerical staff, records, files, and equipment shall be adequate.
(e) Classrooms, laboratories, and conference rooms shall be adequate in number, size,
and type for the number of students and the educational purposes for which the rooms
are used.
(f) The director and faculty shall have secretarial and clerical assistance adequate in
preparation and sufficient in numbers to meet the needs of the program.
(g) The learning resources, library, and program holdings shall be current, use
contemporary technology appropriate for the level of the curriculum, and be sufficient for
the size of the student body and the needs of the faculty.
(1) Provisions shall be made for reasonable accessibility and availability of
information resources.
(2) Facilities and policies shall promote effective use of resources, e.g., environment,
accessibility, and hours of operation.
The provisions of this §219.11 adopted to be effective September 13, 2001, 26 TexReg 6889.
108
§219.12. Records and Reports
(a) Accurate and appropriate records shall be maintained that include, but are not limited
to:
(1) Current records of students;
(2) Transcripts of graduates;
(3) Faculty records;
(4) Administrative records, including minutes of faculty meetings for the past three
years, annual reports of the program, and school bulletins;
(5) The current curriculum, including mission and goals (philosophy and outcomes)
and course outlines;
(6) Agreements with affiliating agencies; and
(7) Master plan of evaluation with most recent data collection.
(b) Records shall be safely stored to prevent loss, destruction, or unauthorized use.
(c) An annual report shall be submitted to the Board by the director on forms provided.
The provisions of this §219.12 adopted to be effective September 13, 2001, 26 TexReg 6889.
§219.13. Total Program Evaluation
There shall be a written plan for the systematic evaluation of the total program. The plan
shall include methodology, frequency of evaluation, assignment of responsibility,
evaluative criteria, and indicators of instructional effectiveness and program outcomes.
The following broad areas shall be periodically evaluated:
(1) Organization and administration of the program;
(2) Mission and goals (philosophy and outcomes);
(3) Program of study, curriculum, and instructional techniques;
(4) Education facilities, resources, and services;
(5) Clinical resources;
(6) Student achievement, e.g., attrition rates, completion rates, length of time for
program completion;
(7) Graduate outcomes, e.g., certification examination pass rates, graduate surveys,
employer surveys; and
(8) Faculty’s performance.
The provisions of this §219.13 adopted to be effective September 13, 2001, 26 TexReg 6889.
CHAPTER 221. ADVANCED PRACTICE NURSES
§221.1. Definitions
The following words and terms, when used in this chapter, shall have the following
meanings unless the context clearly indicates otherwise:
(1) Accredited program—A program which has been deemed to have met certain
standards set by the board or by a national accrediting body recognized by the
board.
(2) Advanced educational program—A post-basic advanced practice nurse program
at the certificate or master’s degree level. Beginning January 1, 2003, a master’s
degree in the advanced practice role and specialty will be required for recognition as
an Advanced Practice Nurse.
109
(3) Advanced practice nurse—A registered nurse approved by the board to practice
as an advanced practice nurse based on completing an advanced educational
program acceptable to the board. The term includes a nurse practitioner, nursemidwife, nurse anesthetist, and a clinical nurse specialist. The advanced practice
nurse is prepared to practice in an expanded role to provide health care to
individuals, families, and/or groups in a variety of settings including but not limited to
homes, hospitals, institutions, offices, industry, schools, community agencies, public
and private clinics, and private practice. The advanced practice nurse acts
independently and/or in collaboration with other health care professionals in the
delivery of health care services.
(4) Authorization to practice—The process of reviewing the educational, licensing,
certification and other credentials of the registered nurse to determine compliance
with the board’s requirements for approval as an advanced practice nurse.
(5) Board—The Board of Nurse Examiners for the State of Texas.
(6) Current certification—Initial certification and maintenance of certification by
national certifying bodies recognized by the board.
(7) Current practice—Maintaining competence as an advanced practice nurse by
practicing in the advanced role and specialty in the clinical setting, practicing as an
educator in the clinical and/or didactic portion of an advanced educational program of
study, or practicing as a consultant or an administrator within the advanced specialty
and role.
(8) Graduate advanced practice nurse—A registered nurse who has completed an
advanced educational program of study and has been granted provisional or interim
authorization by the board to practice in the advanced specialty and role.
(9) Monitored anesthesia care—refers to situations where a patient undergoing a
diagnostic or therapeutic procedure receive doses of medication that create a risk of
loss of normal protective reflexes or loss of consciousness and the patient remains
able to protect the airway for the majority of the procedure. If, for an extended period
of time, the patient is rendered unconscious and/or loses normal protective reflexes,
then anesthesia care shall be considered a general anesthetic.
(10) Outpatient setting—Any facility, clinic, center, office, or other setting that is not a
part of a licensed hospital or a licensed ambulatory surgical center with the exception
of all of the following:
(A) clinic located on land recognized as tribal land by the federal government
and maintained or operated by a federally recognized Indian tribe or tribal
organization as listed under 25 U.S.C. Section 479-1 or as listed under a
successor federal statute or regulation;
(B) a facility maintained or operated by a state or governmental entity;
(C) a clinic directly maintained or operated by the United States or by any of its
departments, officers, or agencies; and
(D) an outpatient setting accredited by either the Joint Commission on
Accreditation of Healthcare Organizations relating to ambulatory surgical
centers, the American Association for the Accreditation of Ambulatory Surgery
Facilities, or the Accreditation Association for Ambulatory Health Care.
(11) Party state—Any state that has entered into the Nurse Licensure Compact.
110
(12) Protocols or other written authorization—Written authorization to provide
medical aspects of patient care which are agreed upon and signed by the advanced
practice nurse and the physician, reviewed and signed at least annually, and
maintained in the practice setting of the advanced practice nurse. Protocols or other
written authorization shall be defined to promote the exercise of professional
judgment by the advanced practice nurse commensurate with his/her education and
experience. Such protocols or other written authorization need not describe the exact
steps that the advanced practice nurse must take with respect to each specific
condition, disease, or symptom and may state types or categories of drugs which
may be prescribed rather that just list specific drugs.
(13) Shall and must—Mandatory requirements.
(14) Should—A recommendation.
(15) Unencumbered—A license to practice registered nursing which does not have
stipulations against the license.
The provisions of this §221.1 adopted to be effective February 25, 2001, 26 TexReg 1509.
§221.2. Authorization and Restrictions to Use of Advanced Practice Titles
(a) Effective January 1, 2006, a registered nurse holding him or herself out to be an
advanced practice nurse shall be authorized to practice and hold a title in the following
categories:
(1) nurse anesthetist;
(2) nurse-midwife;
(3) nurse practitioner in the following specialties:
(A) Acute Care Adult;
(B) Acute Care Pediatric;
(C) Adult;
(D) Family;
(E) Gerontological;
(F) Neonatal;
(G) Pediatric;
(H) Psychiatric/Mental Health;
(I) Women’s Health; and/or
(4) clinical nurse specialist in the following specialties:
(A) Adult Health/Medical-Surgical Nursing;
(B) Community Health Nursing;
(C) Critical Care Nursing;
(D) Gerontological Nursing;
(E) Pediatric Nursing; and
(F) Psychiatric/ Mental Health Nursing.
(b) A registered nurse who holds current authorization to practice as an advanced
practice nurse issued by the board in any of the categories indicated in the previous
subsection shall use that title when functioning in the advanced practice role. A
registered nurse who was granted authorization to practice in an advanced role and
specialty not indicated in the previous subsection prior to January 1, 2006, may continue
to use the advanced practice title approved by the Board provided all requirements for
maintenance of advanced practice authorization are met. ―Advanced practice nurse‖
shall not be used as a title.
111
(c) Unless authorized as an advanced practice nurse by the board as provided for by
§§221.4 - 221.8 of this chapter (relating to Full Authorization, Provisional Authorization;
Interim Approval; Petitions for Waiver; and Maintaining Active Authorization as an
Advanced Practice Nurse), a registered nurse shall not:
(1) claim to be an advanced practice nurse or hold himself/herself out to be an
advanced practice nurse in this state; and/or
(2) use a title or any other designation tending to imply that the person is authorized
as an advanced practice nurse.
(d) A registered nurse who violates subsection (c) of this section may be subject to an
administrative penalty under §301.501 of the Nursing Practice Act.
The provisions of this §221.2 adopted to be effective February 25, 2001, 26 TexReg 1509; amended to
be effective May 15, 2005, 30 TexReg 2668.
§221.3. Education
(a) In order to be eligible to apply for authorization as an advanced practice nurse, the
registered nurse must have completed a post-basic advanced educational program of
study appropriate for practice in an advanced nursing specialty and role recognized by
the Board. RN to BSN programs shall not be considered post-basic programs for the
purpose of this rule.
(b) Individuals prepared in more than one advanced practice role and/or specialty
(including blended role or dual specialty programs) shall be considered to have
completed separate advanced educational programs of study for each role and/or
specialty area.
(c) Applicants for authorization to practice in an advanced role and specialty recognized
by the Board must submit verification of completion of all requirements of an advanced
educational program that meets the following criteria:
(1) Advanced educational programs in the State of Texas shall be approved by the
Board or accredited by a national accrediting body recognized by the Board.
(2) Programs in states other than Texas shall be accredited by a national accrediting
body recognized by the board or by the appropriate licensing body in that state. A
state licensing body’s accreditation process must meet or exceed the requirements
of accrediting bodies specified in board policy.
(3) Programs of study shall be at least one academic year in length and shall include
a formal preceptorship.
(4) Beginning January 1, 2003, the program of study shall be at the graduate degree
level.
(5) Applicants prepared in more than one advanced practice role and/or specialty
shall demonstrate that all curricular requirements set forth in this subsection have
been met for each role and/or specialty.
(d) Applicants for authorization as clinical nurse specialists must submit verification of
the following requirements in addition to those specified in subsection (c) of this section:
(1) completion of a master’s degree in the discipline of nursing, and
(2) completion of a minimum of nine semester credit hours or the equivalent in a
specific clinical major. Clinical major courses must include didactic content and offer
clinical experiences in a specific clinical specialty/practice area.
112
(e) Those applicants who completed nurse practitioner or clinical nurse specialist
programs on or after January 1, 1998 must demonstrate evidence of completion of the
following curricular requirements:
(1) separate, dedicated courses in pharmacotherapeutics, advanced assessment
and pathophysiology and/or psychopathology (psychopathology accepted for
advanced practice nurses prepared in the psychiatric/mental health specialty only).
These must be graduate level academic courses;
(2) evidence of theoretical and clinical role preparation;
(3) evidence of clinical major courses in the specialty area; and
(4) evidence of a practicum/preceptorship/internship to integrate clinical experiences
as reflected in essential content and the clinical major courses.
(5) In this subsection, the following terms have the following definitions:
(A) Advanced Assessment Course means a course that offers content supported
by related clinical experience such that students gain the knowledge and skills
needed to perform comprehensive assessments to acquire data, make
diagnoses of health status and formulate effective clinical management plans.
(B) Pharmacotherapeutics means a course that offers content in
pharmacokinetics and pharmacodynamics, pharmacology of current/commonly
used medications, and the application of drug therapy to the treatment of disease
and/or the promotion of health.
(C) Pathophysiology means a course that offers content that provides a
comprehensive, system-focused pathology course that provides students with
the knowledge and skills to analyze the relationship between normal physiology
and pathological phenomena produced by altered states across the life span.
(D) Role preparation means formal didactic and clinical experiences/content that
prepare nurses to function in an advanced nursing role.
(E) Clinical major courses means courses that include didactic content and offer
clinical experiences in a specific clinical specialty/practice area.
(F) Clinical specialty area means specialty area of clinical practice based upon
formal didactic preparation and clinical experiences.
(G) Essential content means didactic and clinical content essential for the
educational preparation of individuals to function within the scope of advanced
nursing practice. The essential content includes but is not limited to: advanced
assessment, pharmacotherapeutics, role preparation, nursing specialty practice
theory, physiology/pathology, diagnosis and clinical management of health
status, and research.
(H) Practicum/Preceptorship/Internship means a designated portion of a formal
educational program that is offered in a health care setting and affords students
the opportunity to integrate theory and role in both the clinical specialty/practice
area and advanced nursing practice through direct patient care/client
management. Practicums/Preceptorships/Internships are planned and monitored
by either a designated faculty member or qualified preceptor.
(f) Those applicants who complete nurse practitioner or clinical nurse specialist
programs on or after January 1, 2003 must demonstrate evidence of completion of a
minimum of 500 separate, non-duplicated clinical hours for each advanced role and
specialty within the advanced educational program.
The provisions of this §221.3 adopted to be effective February 25, 2001, 26 TexReg 1509; amended to
be effective January 2, 2006, 30 TexReg 8881.
113
§221.4. Requirements for Full Authorization to Practice
(a) The registered professional nurse who seeks authorization to practice as an
advanced practice nurse must:
(1) hold a current, valid, unencumbered license as a registered nurse in the State of
Texas or reside in any party state and hold a current, valid, unencumbered
registered nurse license in that state;
(2) submit to the board such evidence as required by the board to insure compliance
with §221.3 of this chapter (relating to Education);
(3) attest, on forms provided by the board to having met the minimum of 400 hours of
current practice within the preceding biennium unless the applicant has completed
an advanced educational program within the preceding biennium;
(4) attest, on forms provided by the board, to having obtained 20 contact hours of
continuing education in the advanced specialty and role recognized by the board
every two years. Continuing education in the advanced specialty and role must meet
the requirements of chapter 216 of this title (relating to Continuing Education). The
20 contact hours required for RN licensure may be met by the 20 hours required by
this subsection; and
(5) submit the required credentialing fee, which is not refundable.
(b) The applicant for advanced practice nurse authorization who completed an advanced
educational program on or after January 1, 1996 must submit to the board such
evidence as required by the board to ensure the applicant holds current certification in
an the advanced nursing role and specialty recognized by the board. Such certification
must be granted by a national certifying body recognized by the board. The board
reserves the right to designate an available national examination in a closely related
specialty which that must be taken in lieu of an examination specifically related to the
specialty. If an appropriate certification examination is not available and the board has
not designated an alternate examination, the applicant may petition the board for waiver
from the certification requirement, according to §221.7(c) of this chapter (relating to
Petitions for Waiver).
(c) Advanced practice nurse applicants who wish to be authorized by the board for more
than one designation shall complete additional education in the desired area(s) of
approval in compliance with §221.3 of this chapter and obtain national certification in the
advanced role and specialty from a national certifying body recognized by the board. To
apply for authorization for more than one designation, the applicant shall submit a
separate application and fee for each desired designation.
(d) After review by the board, notification of acceptability of credentials and a certificate
verifying approval shall be sent to the advanced practice nurse.
The provisions of this §221.4 adopted to be effective February 25, 2001, 26 TexReg 1509; amended to
be effective March 14, 2002, 27 TexReg 1736; amended to be effective February 20, 2003, 28 TexReg
1383.
114
§221.5. Provisional Authorization
(a) A registered nurse who has completed an advanced educational program as required
by §221.3 of this chapter (relating to Education) and registered for a board approved
national certification examination following completion of the program may be issued a
provisional authorization to practice as a Graduate Advanced Practice Nurse pending
notification of the results of the certification examination. An applicant may be eligible for
provisional authorization only one time per authorized role. The applicant must apply for
provisional authorization within six months of program completion.
(b) The applicant shall request the respective certifying body to notify the board of the
applicant’s certification examination results.
(c) Provisional authorization to practice as a graduate advanced practice nurse shall
expire with the first occurrence of any of the following:
(1) One year from the date of completion of the advanced educational program,
(2) When the applicant receives full authorization to practice as an advanced practice
nurse, or
(3) When the applicant receives notice from the national certifying body that he/she
has failed the national certification examination.
(d) Failure to pass the certification examination on the first attempt will immediately
render the applicant ineligible to practice in the advanced practice role or utilize
advanced practice titles. The provisional authorization to practice is rescinded and the
application for full authorization to practice is denied.
(1) The applicant must immediately notify the board of the examination results and
return the original provisional authorization to practice document to the board’s office
accompanied by a photocopy of the examination results.
(2) The applicant who fails to pass the certification examination on the first attempt
may continue to test until he/she achieves national certification in the advanced role
and specialty.
(3) An applicant who fails to pass the certification examination may continue to
practice as a registered nurse.
(A) The applicant may not:
(i) Practice as an advanced practice nurse,
(ii) Claim to be an advanced practice nurse or hold himself/herself out to be
an advanced practice nurse, or
(iii) Use a title or any other designation tending to imply that the person is
authorized as an advanced practice nurse.
(B) The applicant may utilize his/her advanced knowledge, skills, and abilities if
an advanced practice nurse authorized to practice in the same role and an
appropriate specialty or a physician in the specialty area:
(i) Agrees to continuously monitor all aspects of the applicant’s practice that
are beyond the scope of practice of a registered nurse,
(ii) Assumes complete responsibility for all aspects of the care and services
provided by the applicant that are beyond the scope of practice of the
registered nurse,
(iii) Co-signs all documentation, and
(iv) Continuously remains on site with the applicant and is physically present
or immediately available at all times.
115
(4) When the applicant obtains national certification in the advanced role and
specialty, he/she may be eligible to reapply for authorization to practice as an
advanced practice nurse. The applicant must meet all requirements for full
authorization to practice as an advanced practice nurse as specified in §221.4 of this
chapter at the time he/she reapplies.
The provisions of this §221.5 adopted to be effective February 25, 2001, 26 TexReg 1509; amended to
be effective February 20, 2003, 28 TexReg 1383.
§221.6. Interim Approval
(a) Interim approval may be granted by the board pending completion of the application
process for a period not to exceed 90 days. Extensions of the interim approval period
shall not be granted.
(1) The registered nurse seeking interim approval as an advanced practice nurse
must complete documentation provided by the board verifying that he/she meets all
requirements of this chapter and has completed and mailed the appropriate
documents to the educational program or organization for completion.
(2) A letter shall be issued by the board granting interim approval.
(3) An applicant is eligible for interim approval one time only per specialty and role.
(b) An applicant who submits a request for waiver from the requirements of the rules as
set forth in §221.4 (relating to Full Authorization to Practice) and §221.5 (relating to
Provisional Authorization) of this chapter shall not be eligible for interim approval.
(c) If an applicant is deemed ineligible for advanced practice authorization, the interim
approval will be rescinded immediately, effective on the date the notice is sent by mail.
The applicant must cease holding him/herself out as or using titles to imply that he/she is
an advanced practice nurse.
The provisions of this §221.6 adopted to be effective February 25, 2001, 26 TexReg 1509.
§221.7. Petitions for Waiver and Exemptions
(a) A registered nurse who submits a request for waiver from requirements of the rules
must submit documentation as required by the board to support his or her petition and
assure the board that he or she possesses the knowledge, skills and abilities appropriate
for the role and specialty desired. Those petitioners who are under investigation or
current board order are not eligible for waiver.
(b) Petitions for waiver from the program accreditation requirements of §221.3 of this
chapter (relating to Education), may be granted by the board for individuals who
completed their educational programs on or before December 31, 1996. Petitioners must
meet the length of academic program requirements of §221.3 of this chapter and obtain
national certification in the advanced role and specialty area.
(c) Petitions for waiver from the current certification requirements of §221.4 of this
chapter (relating to Requirements for Full Authorization to Practice) and §221.8 of this
chapter (relating to Maintaining Active Authorization as an Advanced Practice Nurse)
may be granted by the board.
(1) Under this section, only those petitioners for which no national certification
examination within the advanced role and specialty or a related advanced specialty
exists will be considered for waiver by the board.
(2) The board may determine that an available national certification examination in a
related specialty and/or role must be taken in lieu of an examination specific to the
advanced specialty area.
116
(d) Waivers from the master’s degree requirement will be granted to qualified certificateprepared nurse-midwives and women’s health care nurse practitioners who complete
their programs on or after January 1, 2003 through December 31, 2006. Applicants must
meet all other requirements as stated in §221.4 of this chapter.
(1) Those individuals approved on the basis of this waiver shall be limited to
providing advanced practice nursing care within the geographical boundaries of the
State of Texas. This shall not prevent the individual from utilizing Nurse Licensure
Compact privileges to function as a registered nurse.
(2) The applicant must submit all required documentation necessary to demonstrate
that the requirements (except for the master’s degree) for authorization to practice
have been met.
(3) The applicant must submit a written request for waiver of the master’s degree
requirement.
(4) Interim, provisional or full authorization may be granted to qualified certificateprepared nurse-midwives and women’s health care nurse practitioners.
(e) Exemptions granting authorization to utilize titles not authorized by §221.2 of this
chapter may be granted to qualified applicants who complete their advanced educational
programs prior to January 1, 2010. Applicants must meet all other requirements as
stated in §221.4 of this chapter,
(1) The following specialty titles may be considered for exemption if the individual is
not qualified for authorization to utilize a title authorized by §221.2 of this chapter:
(A) Acute Care Clinical Nurse Specialist,
(B) Critical Care Nurse Practitioner;
(C) Cardiovascular Clinical Nurse Specialist;
(D) Emergency Nurse Practitioner or Clinical Nurse Specialist;
(E) Family Clinical Nurse Specialist;
(F) Home Health Clinical Nurse Specialist;
(G) Maternal (Parent)-Child Health Clinical Nurse Specialist (with or without
subspecialization);
(H) Neonatal Clinical Nurse Specialist;
(I) Oncology Nurse Practitioner or Clinical Nurse Specialist;
(J) Pediatric Critical Care Nurse Practitioner;
(K) Perinatal Nurse Practitioner or Clinical Nurse Specialist;
(L) School Nurse Practitioner; and
(M)Women’s Health Clinical Nurse Specialist.
(2) Those individuals authorized on the basis of this exemption shall be limited to
providing advanced practice nursing care within the geographical boundaries of the
State of Texas. This shall not prevent the individual from utilizing Nurse Licensure
Compact privileges to function as a registered nurse.
(3) The applicant must submit all required documentation necessary to demonstrate
that all requirements for authorization to practice have been met.
(4) The applicant must submit a written request for exemption to §221.2 of this
chapter and indicate the desired title
(5) Interim, provisional, or full authorization may be granted to qualified applicants.
(6) Advanced practice nurses authorized to practice on the basis of this exemption
shall use the advanced practice title specified on the authorization to practice
document provided by the board.
The provisions of this §221.7 adopted to be effective February 25, 2001, 26 TexReg 1509; amended to
be effective May 15, 2005, 30 TexReg 2668.
117
§221.8. Maintaining Active Authorization as an Advanced Practice Nurse
(a) In conjunction with RN license renewal, the advanced practice nurse seeking to
maintain active advanced practice authorization(s) shall:
(1) attest on forms provided by the board to maintaining current national certification
by the appropriate certifying body recognized by the board. This requirement shall
apply to advanced practice nurses who:
(A) completed an advanced educational program on or after January 1, 1996, or
(B) were authorized as advanced practice nurses based upon obtaining national
certification.
(2) attest, on forms provided by the board, to having a minimum of 400 hours of
current practice within the preceding biennium;
(3) attest, on forms provided by the board, to having obtained 20 contact hours of
continuing education in the advanced specialty area and role within the preceding
biennium. Continuing education in the advanced practice specialty and role must
meet requirements of Chapter 216 of this title (relating to Continuing Education). The
20 contact hours required for RN licensure may be met by the 20 hours required by
this subsection; and
(4) submit the required fee, which is not refundable.
(b) Failure to renew the registered nurse license or to provide the required fee and
documentation for maintaining authorization shall result in expiration of the board’s
authorization as an advanced practice nurse and limited prescriptive authority where
applicable. The individual whose advanced practice authorization has expired may
not practice as or use titles to imply that he/she is an advanced practice nurse.
The provisions of this §221.8 adopted to be effective February 25, 2001, 26 TexReg 1509.
§221.9. Inactive Status
(a) The advanced practice nurse may choose to change advanced practice nurse status
to inactive by providing a written request for such change.
(b) Inactive advanced practice status means that the registered professional nurse may
not practice in the advanced practice specialty and role and may not hold himself/herself
out to be an advanced practice nurse by using titles which imply that he/she is an
advanced practice nurse. The inactive advanced practice nurse may not utilize
his/ her limited prescriptive authority.
The provisions of this §221.9 adopted to be effective February 25, 2001, 26 TexReg 1509.
§221.10. Reinstatement or Reactivation of Advanced Practice Nurse Status
(a) To reinstate an authorization which has expired due to non-payment of renewal fees
for registered nurse licensure and/or advanced practice authorization, the advanced
practice nurse shall meet the requirements as stated in §221.8 of this chapter (relating to
Maintaining Active Authorization as an Advanced Practice Nurse) and pay all required
fees.
118
(b) If less than four years but more than two years have lapsed since completion of the
advanced educational program and/or the applicant does not have 400 hours of current
practice in the advanced role and specialty during the previous biennium, the advanced
practice nurse shall meet the requirements as stated in §221.8 of this chapter and pay
all required fees. The applicant shall be required to demonstrate proof of completion of
400 hours of current practice as well as the continuing education requirement as outlined
in Chapter 216 of this title (relating to Continuing Education). The 400 hours of current
practice shall be obtained under the direct supervision of an advanced practice nurse
authorized by the board in the same role and specialty or by a physician the same
specialty.
(c) If more than four years have lapsed since completion of the advanced practice
educational program and/or the applicant has not practiced in the advanced role during
the previous four years, the applicant shall apply for reactivation and meet current
requirements for maintaining authorization to practice under §221.8 of this
chapter and shall:
(1) hold a current, valid, unencumbered license as a registered nurse in the State of
Texas or reside in any party state and hold a current, valid, unencumbered
registered nurse license in that state; and
(2) successfully complete a refresher course or extensive orientation in the
appropriate advanced practice specialty and role which includes a supervised clinical
component by a qualified instructor/sponsor.
(A) The course(s)/orientation shall be of sufficient length to satisfy the learning
needs of the inactive advanced practice nurse and to assure that he/she meets
the minimum standard for safe, competent care. The course(s)/orientation shall
cover the entire scope of the authorized advanced specialty area. Content shall
include, but not be limited to that which is specified in board guidelines.
(B) The instructor/sponsor must provide written verification of satisfactory
completion of the course/orientation on forms provided by the board and
assurance that the individual has reviewed current practice-related information
pertinent to his/her advanced specialty and role.
The provisions of this §221.10 adopted to be effective February 25, 2001, 26 TexReg 1509.
§221.11. Identification
When providing advanced practice nursing care to patients, the advanced practice nurse
shall wear clear identification which indicates the individual is a registered nurse with the
appropriate advanced practice designation authorized by the board.
The provisions of this §221.11 adopted to be effective February 25, 2001, 26 TexReg 1509.
119
§221.12. Scope of Practice
The advanced practice nurse provides a broad range of health services, the scope of
which shall be based upon educational preparation, continued advanced practice
experience and the accepted scope of professional practice of the particular specialty
area. Advanced practice nurses practice in a variety of settings and, according to their
practice specialty and role, they provide a broad range of health care services to a
variety of patient populations.
(1) The scope of practice of particular specialty areas shall be defined by national
professional specialty organizations or advanced practice nursing organizations
recognized by the Board. The advanced practice nurse may perform only those
functions which are within that scope of practice and which are consistent with the
Nursing Practice Act, Board rules, and other laws and regulations of the State of
Texas.
(2) The advanced practice nurse’s scope of practice shall be in addition to the scope
of practice permitted a registered nurse and does not prohibit the advanced practice
nurse from practicing in those areas deemed to be within the scope of practice of a
registered nurse.
The provisions of this §221.12 adopted to be effective February 25, 2001, 26 TexReg 1509.
§221.13. Core Standards for Advanced Practice
(a) The advanced practice nurse shall know and conform to the Texas Nursing Practice
Act; current board rules, regulations, and standards of professional nursing; and all
federal, state, and local laws, rules, and regulations affecting the advanced role and
specialty area. When collaborating with other health care providers, the advanced
practice nurse shall be accountable for knowledge of the statutes and rules relating to
advanced practice nursing and function within the boundaries of the appropriate
advanced practice category.
(b) The advanced practice nurse shall practice within the advanced specialty and role
appropriate to his/her advanced educational preparation.
(c) The advanced practice nurse acts independently and/or in collaboration with the
health team in the observation, assessment, diagnosis, intervention, evaluation,
rehabilitation, care and counsel, and health teachings of persons who are ill, injured or
infirm or experiencing changes in normal health processes; and in the promotion and
maintenance of health or prevention of illness.
(d) When providing medical aspects of care, advanced practice nurses shall utilize
mechanisms which provide authority for that care. These mechanisms may include, but
are not limited to, Protocols or other written authorization. This shall not be construed as
requiring authority for nursing aspects of care.
(1) Protocols or other written authorization shall promote the exercise of professional
judgment by the advanced practice nurse commensurate with his/her education and
experience. The degree of detail within protocols/policies/practice guidelines/clinical
practice privileges may vary in relation to the complexity of the situations covered by
such Protocols, the advanced specialty area of practice, the advanced educational
preparation of the individual, and the experience level of the individual advanced
practice nurse.
120
(2) Protocols or other written authorization:
(A) should be jointly developed by the advanced practice nurse and the
appropriate physician(s),
(B) shall be signed by both the advanced practice nurse and the physician(s),
(C) shall be reviewed and re-signed at least annually,
(D) shall be maintained in the practice setting of the advanced practice nurse,
and
(E) shall be made available as necessary to verify authority to provide medical
aspects of care.
(e) The advanced practice nurse shall retain professional accountability for advanced
practice nursing care.
The provisions of this §221.13 adopted to be effective February 25, 2001, 26 TexReg 1509.
§221.14. Nurse-Midwives Providing Controlled Substances
(a) In this section ―provide‖ means to supply, for a term not to exceed 48 hours, one or
more unit doses of a controlled substance for the immediate needs of a patient;
(b) An advanced practice nurse recognized by the board as a nurse-midwife may
provide one or more unit doses of a controlled substance during intra-partum or
immediate post-partum care subject to the following conditions:
(1) Physician delegation of authority to provide controlled substances must be made
through a physician’s order, medical order, standing delegation order, or protocol
that requires adequate and documented availability for access to medical care.
Delegation may not include the use of a prescription sticker or the use or issuance of
an official prescription form under §481.075, Health and Safety Code;
(2) The nurse-midwife’s protocols or other orders must require the reporting of or
monitoring of each patient’s progress, including complications of pregnancy and
delivery and the administration and provision of controlled substances to the patient;
(3) delegation is limited to three full-time equivalent nurse-midwives at the
designated facility where the nurse midwife practices; and
(4) the controlled substance must be supplied in a suitable container that is labeled
in compliance with the applicable drug laws and must include:
(A) the patient’s name and address;
(B) the drug to be provided;
(C) the name, address, and telephone number of the physician;
(D) the name, address, and telephone number of the nurse-midwife; and
(E) the date.
The provisions of this §221.14 adopted to be effective February 25, 2001, 26 TexReg 1509.
121
§221.15. Provision of Anesthesia Services by Nurse Anesthetists in Licensed Hospitals
or Ambulatory Surgical Centers
(a) In a licensed hospital or ambulatory surgical center, consistent with facility policy or
medical staff bylaws, a nurse anesthetist may select, obtain, and administer drugs
including determination of appropriate dosages, techniques and medical devices for their
administration and in maintaining the patient in sound physiologic status pursuant to a
physician’s order for anesthesia or an anesthesia-related service. This order need not be
drug specific, dosage specific, or administration-technique specific.
(b) Pursuant to a physician’s order for anesthesia or an anesthesia-related service, the
nurse anesthetist may order anesthesia-related medications during perianesthesia
periods in the preparation for or recovery from anesthesia. Another RN may carry out
these orders.
(c) In providing anesthesia or an anesthesia-related service, the nurse
anesthetist shall select, order, obtain and administer drugs which fall within categories of
drugs generally utilized for anesthesia or anesthesia-related services and provide the
concomitant care required to maintain the patient in sound physiologic status during
those experiences.
The provisions of this §221.15 adopted to be effective February 25, 2001, 26 TexReg 1509.
§221.16. Provision of Anesthesia Services by Nurse Anesthetists in Outpatient Settings
(a) Purpose. The purpose of these rules is to identify the roles, and responsibilities of
certified registered nurse anesthetists authorized to provide anesthesia services in
outpatient settings and to provide the minimum acceptable standards for the provision of
anesthesia services in outpatient settings.
(1) On or after August 31, 2000 certified registered nurse anesthetists shall comply
with subsections (b)(2)-(e) of this section in order to be authorized to provide general
anesthesia, regional anesthesia, or monitored anesthesia care in outpatient settings.
This requirement shall include certified registered nurse anesthetists administering
any inhaled anesthetic agents, including, but not limited to, nitrous oxide, due to the
significant variability in patient response to such drugs.
(2) Subsections (b)(2)-(e) of this section do not apply to the registered nurse
anesthetist who practices in the following:
(A) an outpatient setting in which only local anesthesia, peripheral nerve blocks,
or both are used;
(B) an outpatient setting in which only anxiolytics and analgesics are used and
only in doses that do not have the probability of placing the patient at risk for loss
of the patient’s life-preserving protective reflexes;
(C) a licensed hospital, including an outpatient facility of the hospital that is
separately located apart from the hospital;
(D) a licensed ambulatory surgical center;
(E) a clinic located on land recognized as tribal land by the federal government
and maintained or operated by a federally recognized Indian tribe or tribal
organization as listed by the United States secretary of the
interior under 25 U.S.C. Section 479-1 or as listed under a successor federal
statute or regulation
(F) a facility maintained or operated by a state or governmental entity;
(G) a clinic directly maintained or operated by the United States or by any of its
departments, officers, or agencies; and
122
(H) an outpatient setting accredited by
(i) the Joint Commission on Accreditation of Healthcare Organizations
relating to ambulatory surgical centers;
(ii) the American Association for the Accreditation of Ambulatory Surgery
Facilities,
(iii) the Accreditation Association for Ambulatory Health Care.
(b) Roles and Responsibilities
(1) Certified registered nurse anesthetists shall follow current, applicable standards
and guidelines as put forth by the American Association of Nurse Anesthetists
(AANA) and other relevant national standards regarding the practice of nurse
anesthesia as adopted by the AANA or the Board.
(2) Certified registered nurse anesthetists shall comply with all building, fire, and
safety codes. A two-way communication source not dependent on electrical current
shall be available. Each location should have sufficient electrical outlets to satisfy
anesthesia machine and monitoring equipment requirements, including clearly
labeled outlets connected to an emergency power supply. Sites shall also have a
secondary power source as appropriate for equipment in use in case of power
failure.
(3) In an outpatient setting, where a physician has delegated to a certified registered
nurse anesthetist the ordering of drugs and devices necessary for the nurse
anesthetist to administer an anesthetic or an anesthesia-related service ordered by a
physician, a certified registered nurse anesthetist may select, obtain and administer
drugs, including determination of appropriate dosages, techniques and medical
devices for their administration and in maintaining the patient in sound physiologic
status. This order need not be drug-specific, dosage specific, or administrationtechnique specific. Pursuant to a physician’s order for anesthesia or an anesthesia
related service, the certified registered nurse anesthetist may order anesthesiarelated medications during perianesthesia periods in the preparation for or recovery
from anesthesia. In providing anesthesia or an anesthesia-related service, the
certified registered nurse anesthetist shall select, order, obtain and administer drugs
which fall within categories of drugs generally utilized for anesthesia or anesthesiarelated services and provide the concomitant care required to maintain the patient in
sound physiologic status during those experiences.
(c) Standards.
(1) The certified registered nurse anesthetist shall perform a pre-anesthetic
assessment, counsel the patient, and prepare the patient for anesthesia per current
AANA standards. Informed consent for the planned anesthetic intervention shall be
obtained from the patient/legal guardian and maintained as part of the medical
record. The consent must include explanation of the technique, expected results, and
potential risks/complications. Appropriate pre-anesthesia diagnostic testing and
consults shall be obtained per indications and assessment findings.
123
(2) Physiologic monitoring of the patient shall be determined by the type of
anesthesia and individual patient needs. Minimum monitoring shall include
continuous monitoring of ventilation, oxygenation, and cardiovascular status.
Monitors shall include, but not be limited to, pulse oximetry and EKG continuously
and non-invasive blood pressure to be measured at least every five minutes. If
general anesthesia is utilized, then an O2 analyzer and end-tidal CO2 analyzer must
also be used. A means to measure temperature shall be readily available and utilized
for continuous monitoring when indicated per current AANA standards. An audible
signal alarm device capable of detecting disconnection of any component of the
breathing system shall be utilized. The patient shall be monitored continuously
throughout the duration of the procedure by the certified registered nurse anesthetist.
Postoperatively, the patient shall be evaluated by continuous monitoring and clinical
observation until stable by a licensed health care provider. Monitoring and
observations shall be documented per current AANA standards. In the event of an
electrical outage which disrupts the capability to continuously monitor all specified
patient parameters, at a minimum, heart rate and breath sounds will be monitored on
a continuous basis using a precordial stethoscope or similar device, and blood
pressure measurements will be reestablished using a non-electrical blood pressure
measuring device until electricity is restored.
(3) All anesthesia-related equipment and monitors shall be maintained to current
operating room standards. All devices shall have regular service/maintenance
checks at least annually or per manufacturer recommendations.
Service/maintenance checks shall be performed by appropriately qualified
biomedical personnel. Prior to the administration of anesthesia, all
equipment/monitors shall be checked using the current FDA recommendations as a
guideline. Records of equipment checks shall be maintained in a separate, dedicated
log which must be made available upon request. Documentation of any criteria
deemed to be substandard shall include a clear description of the problem and the
intervention. If equipment is utilized despite the problem, documentation must clearly
indicate that patient safety is not in jeopardy. All documentation relating to equipment
shall be maintained for a period of time as determined by board guidelines.
(4) Each location must have emergency supplies immediately available. Supplies
should include emergency drugs and equipment appropriate for the purpose of
cardiopulmonary resuscitation. This must include a defibrillator, difficult airway
equipment, and drugs and equipment necessary for the treatment of malignant
hyperthermia if ―triggering agents‖ associated with malignant hyperthermia are used
or if the patient is at risk for malignant hyperthermia. Equipment shall be
appropriately sized for the patient population being served. Resources for
determining appropriate drug dosages shall be readily available. The emergency
supplies shall be maintained and inspected by qualified personnel for presence and
function of all appropriate equipment and drugs at intervals established by protocol to
ensure that equipment is functional and present, drugs are not expired, and office
personnel are familiar with equipment and supplies. Records of emergency supply
checks shall be maintained in a separate, dedicated log and made available upon
request. Records of emergency supply checks shall be maintained for a period of
time as determined by board guidelines.
124
(5) Certified registered nurse anesthetists shall maintain current competency in
advanced cardiac life support and must demonstrate proof of continued competency
upon re-registration with the Board. Competency in pediatric advanced life support
shall be maintained for those certified registered nurse anesthetists whose practice
includes pediatric patients. Certified registered nurse anesthetists shall verify that at
least one person in the setting other than the person performing the operative
procedure maintains current competency in basic life support (BLS) at a minimum.
(6) Certified registered nurse anesthetists shall verify that the appropriate policies or
procedures are in place. Policies, procedures, or protocols shall be evaluated and
reviewed at least annually. Agreements with local emergency medical service (EMS)
shall be in place for purposes of transfer of patients to the hospital in case of an
emergency. EMS agreements shall be evaluated and re-signed at least annually.
Policies, procedures, and transfer agreements shall be kept on file in the setting
where procedures are performed and shall be made available upon request. Policies
or procedures must include, but are not limited to:
(A) Management of outpatient anesthesia-At a minimum, these must address:
(i) Patient selection criteria
(ii) Patients/providers with latex allergy
(iii) Pediatric drug dosage calculations, where applicable
(iv) ACLS algorithms
(v) Infection control
(vi) Documentation and tracking use of pharmaceuticals: including controlled
substances, expired drugs
and wasting of drugs
(vii) Discharge criteria
(B) Management of emergencies to include, but not be limited to:
(i) Cardiopulmonary emergencies
(ii) Fire
(iii) Bomb threat
(iv) Chemical spill
(v) Natural disasters
(vi) Power outage
(C) EMS response and transport—Delineation of responsibilities of the certified
registered nurse anesthetist and person performing the procedure upon arrival of
EMS personnel. This policy should be developed jointly with EMS personnel to
allow for greater accuracy.
(D) Pursuant to §217.11(16) of this title (relating to Standards of Professional
Nursing Practice), adverse reactions/events, including but not limited to those
resulting in a patient’s death intraoperatively or within the immediate
postoperative period shall be reported in writing to the Board and other
applicable agencies within 15 days. Immediate postoperative period shall be
defined as 72 hours.
125
(d) Registration.
(1) Beginning April 1, 2000, each certified registered nurse anesthetist who intends
to provide anesthesia services in an outpatient setting must register with the board
and submit the required registration fee, which is nonrefundable.
The information provided on the registration form shall include, but not be limited
to, the name and business address of each outpatient setting(s) and proof of current
competency in advanced life support.
(2) Registration as an outpatient anesthesia provider must be renewed and the
registration renewal fee paid on a biennial basis, at the time of registered nurse
licensure renewal.
(e) Inspections and Advisory Opinions.
(1) The Board may conduct on-site inspections of outpatient settings, including
inspections of the equipment owned or leased by a certified registered nurse
anesthetist and of documents that relate to provision of anesthesia in an outpatient
setting, for the purpose of enforcing compliance with the minimum standards.
Inspections may be conducted as an audit to determine compliance with the
minimum standards or in response to a complaint. The Board may contract with
another state agency or qualified person to conduct these inspections. Unless it
would jeopardize an ongoing investigation, the board shall provide the certified
registered nurse anesthetist at least five business days’ notice before conducting an
on-site inspection.
(2) The Board may, at its discretion and on payment of a fee, conduct on-site
inspections of outpatient settings in response to a request from a certified registered
nurse anesthetist for an inspection and advisory opinion.
(A) The Board may require a certified registered nurse anesthetist to submit and
comply with a corrective action plan to remedy or address current or potential
deficiencies with the nurse anesthetist’s provision of anesthesia in an outpatient
setting.
(B) A certified registered nurse anesthetist who requests and relies on an
advisory opinion of the board may use the opinion as mitigating evidence in an
action or proceeding by the board to impose an administrative
penalty or assess a monetary fine. The board shall take proof of reliance on an
advisory opinion into consideration and mitigate the imposition of administrative
penalties or the assessment of a monetary fine accordingly.
(C) An advisory opinion issued by the board is not binding on the board and the
board except as provided for in subsection (a) of this section, may take any
action in relation to the situation addressed by the advisory opinion that the
Board considers appropriate.
The provisions of this §221.16 adopted to be effective February 25, 2001, 26 TexReg 1509.
126
§221.17. Enforcement
(a) The board may conduct an audit to determine compliance with §221.4 of this chapter
(relating to Requirements for Full Authorization to Practice), §221.8 of this chapter
(relating to Maintaining Active Authorization as an Advanced Practice Nurse), and
§221.16 of this chapter (relating to Provision of Anesthesia Services by Nurse
Anesthetists in Outpatient Settings).
(b) Any nurse who violates the rules set forth in this chapter shall be subject to
disciplinary action and/or termination of the authorization by the board under Texas
Occupations Code, §301.452.
The provisions of this §221.17 adopted to be effective February 25, 2001, 26 TexReg 1509.
CHAPTER 222. ADVANCED PRACTICE NURSES WITH PRESCRIPTIVE AUTHORITY
§222.1. Definitions
The following words and terms when used in this chapter shall have the following
meanings unless the context clearly indicates otherwise:
(1) Advanced practice nurse—A registered nurse approved by the board to practice
as an advanced practice nurse based on completing an advanced educational
program acceptable to the board. The term includes a nurse practitioner, nursemidwife, nurse anesthetist, and a clinical nurse specialist. The advanced practice
nurse is prepared to practice in an expanded role to provide health care to
individuals, families, and/or groups in a variety of settings including but not limited to
homes, hospitals, institutions, offices, industry, schools, community agencies, public
and private clinics, and private practice. The advanced practice nurse acts
independently and/or in collaboration with other health care professionals in the
delivery of health care services.
(2) Alternate site—A practice site:
(A) Where services similar to the services provided at the delegating physician’s
primary practice site are provided; and
(B) Located within 60 miles of the delegating physician’s primary practice site.
(3) Board—The Board of Nurse Examiners for the State of Texas
(4) Carrying out or signing a prescription drug order—Completing a prescription drug
order presigned by the delegating physician or signing (writing) a prescription by an
advanced practice nurse after that person has been designated to the Board of
Medical Examiners by the delegating physician as a person delegated to sign a
prescription.
(5) Controlled substance—A substance, including a drug, an adulterant, and a
dilutant, listed in Schedules I through V or Penalty Groups 1, 1-A, or 2 through 4 of
chapter 481 Texas Health and Safety Code (Texas Controlled
Substances Act). The term includes the aggregate weight of any mixture, solution, or
other substance containing a controlled substance.
(6) Dangerous drug—A device or a drug that is unsafe for self medication and that is
not included in schedules I-V or penalty groups I-IV of chapter 481 Texas Health and
Safety Code (Texas Controlled Substances Act). The term includes a device or a
drug that bears or is required to bear the legend: ―Caution: federal law prohibits
dispensing without prescription‖ or ―RX only‖ or another legend that complies with
federal law.
(7) Diagnosis and management course—A course offering both didactic and clinical
content in clinical decision making and aspects of medical diagnosis and medical
management of diseases and conditions. Supervised clinical
127
practice must include the opportunity to provide pharmacological and nonpharmacological management of diseases and problems considered within the
scope of practice of the advanced practice nurse’s specialty and role.
(8) Eligible sites—Sites serving medically underserved populations; a physician’s
primary practice site; an alternate site; or a facility-based practice site.
(9) Facility-based practice site—A licensed hospital or licensed long term care facility
that serves as the practice location for the advanced practice nurse.
(10) Health Manpower Shortage Area—An urban or rural area, population group, or
public or nonprofit private medical facility or other facility that the Secretary of the
United States Department of Health and Human Services (USDHHS) designates as
having a health manpower shortage, as described by 42 USC Section 254e(a)(1) or
a successor federal statute or regulation.
(11) Medically Underserved Area (MUA)
(A) An urban or rural area or population group that the Secretary of the United
States Department of Health and Human Services (USDHHS) designates as
having a shortage of those services as described by 42 USC Section 300e-1(7)
or a successor federal statute or regulation; or
(B) an area defined as medically underserved by rules adopted by the Texas
Board of Health (Texas Department of Health) based on demographics specific
to this State, geographic factors that affect access to health care, and
environmental health factors.
(12) Pharmacotherapeutics course—A course that offers content in
pharmacokinetics and pharmacodynamics, pharmacology of current/commonly used
medications, and the application of drug therapy to the treatment of disease and/or
the promotion of health.
(13) Physician’s primary practice site—
(A) the practice location at which the physician spends the majority of the
physician’s time;
(B) a licensed hospital, a licensed long-term care facility, or a licensed adult care
center where both the physician and the APN are authorized to practice;
(C) a clinic operated by or for the benefit of a public school district to provide
care to the students of that district and the siblings of those students, if consent
to treatment at that clinic is obtained in a manner that complies with Chapter 32,
Family Code;
(D) the residence of an established patient; or
(E) another location at which the physician is physically present with the
advanced practice nurse.
(14) Protocols or other written authorization—Written authorization to provide
medical aspects of patient care that are agreed upon and signed by the APN and the
physician, reviewed and signed at least annually, and maintained in the practice
setting of the APN. Protocols or other written authorization shall be defined to
promote the exercise of professional judgment by the APN commensurate with
his/her education and experience. Such protocols or other written authorization need
not describe the exact steps that the APN must take with respect to each specific
condition, disease, or symptom and may state types or categories of drugs that may
be prescribed rather than just list specific drugs.
(15) Shall and must—Mandatory requirements.
(16) Should—A recommendation.
128
(17) Site serving a medically underserved population—
(A) a site located in a medically underserved area;
(B) a site located in a health manpower shortage area;
(C) a clinic designated as a rural health clinic under 42 USC 1395x(aa);
(D) a public health clinic or a family planning clinic under contract with the Texas
Department of Human Services for the Texas Department of Health;
(E) a site located in an area in which the Texas Department of Health
determines there is an insufficient number of physicians providing services to
eligible clients of federal, state, or locally funded health care programs; or
(F) a site that the Texas Department of Health determines serves a
disproportionate number of clients eligible to participate in federal, state, or
locally funded health care programs
The provisions of this §222.1 adopted to be effective November 26, 2003, 28 TexReg 10502.
§222.2. Approval for Prescriptive Authority
(a) Credentials: To be approved by the board to carry out or sign prescription drug
orders and issued a prescription authorization number, a Registered Nurse (RN) shall:
(1) have full or provisional authorization by the board to practice as an advanced
practice nurse.
(A) RNs with provisional authorization to practice as graduate advanced practice
nurses who are eligible for prescription authorization numbers shall be limited to
prescribing for categories of dangerous drugs only.
(B) RNs with Interim Authorization to practice as advanced practice nurses are
not eligible for a prescription authorization number;
(2) file a complete application for Prescriptive Authority and submit such evidence as
required by the board to verify the following educational qualifications:
(A) To be eligible for Prescriptive Authority, advanced practice nurses must have
successfully completed courses in pharmacotherapeutics, pathophysiology,
advanced assessment, and diagnosis and management of problems within the
clinical specialty.
(i) Nurse Practitioners, Nurse-Midwives and Nurse Anesthetists will be
considered to have met the course requirements of this section on the basis
of courses completed in the advanced educational program.
(ii) Clinical Nurse Specialists shall submit documentation of successful
completion of separate courses in the content areas described in subsection
(A) of this section. These courses shall be academic courses from a
regionally accredited institution with a minimum of 45 clock hours per course.
(iii) The board, by policy, may determine that certain specialties of Clinical
Nurse Specialists meet one or more of the course requirements on the basis
of the advanced educational program.
(B) Clinical Nurse Specialists who have been approved by the board as
advanced practice nurses by petition on the basis of completion of a non-nursing
master’s degree shall not be eligible for prescriptive authority.
129
(b) Sites: Prescribing privileges are limited to eligible sites to include sites serving certain
medically underserved populations, physician’s primary practice sites, alternate sites,
and facility-based practice sites.
(c) Exceptions Granted by the Texas State Board of Medical Examiners: Requirements
for utilizing limited prescriptive authority may be modified or waived if a delegating
physician has received a modification or waiver from the Texas State Board of Medical
Examiners of any site or supervision requirements for a physician to delegate the
carrying out or signing of prescription drug orders to the advanced practice nurse.
The provisions of this §222.2 adopted to be effective November 26, 2003, 28 TexReg 10502.
§222.3. Renewal of Prescriptive Authority
(a) The advanced practice nurse shall renew the privilege to carry out or sign
prescription drug orders in conjunction with the RN license renewal application.
(b) The advanced practice nurse seeking to maintain prescriptive authority shall attest,
on forms provided by the board, to completing at least five contact hours of continuing
education in pharmacotherapeutics within the preceding biennium.
(c) The continuing education requirement in subsection (b) of this section, shall be in
addition to continuing education required under Chapter 216 of this title (relating to
Continuing Education).
The provisions of this §222.3 adopted to be effective November 26, 2003, 28 TexReg 10502.
§222.4. Minimum Standards for Carrying Out or Signing Prescriptions
(a) The advanced practice nurse with a valid prescription authorization number:
(1) shall carry out or sign prescription drug orders for only those drugs that are:
(A) authorized by Protocols or other written authorization for medical aspects of
patient care; and
(B) prescribed for patient populations within the accepted scope of professional
practice for the advanced practice nurse’s specialty area; and
(2) shall comply with the requirements for adequate physician supervision published
in the rules of the Board of Medical Examiners relating to Delegation of the Carrying
Out or Signing of Prescription Drug Orders to Physician Assistants and Advanced
Practice Nurses as well as other applicable laws,
(b) Protocols or other written authorization shall be defined in a manner that promotes
the exercise of professional judgment by the advanced practice nurse commensurate
with the education and experience of that person.
(1) A protocol or other written authorization:
(A) is not required to describe the exact steps that the advanced practice nurse
must take with respect to each specific condition, disease, or symptom; and
(B) may state types or categories of medications that may be prescribed or
contain the types or categories of medications that may not be prescribed.
(2) Protocols or other written authorization:
(A) shall be written, agreed upon and signed by the advanced practice nurse and
the physician
(B) reviewed and signed at least annually; and
(C) maintained in the practice setting of the advanced practice nurse.
130
(c) Prescription Information: The format and essential elements of the prescription shall
comply with the requirements of the Texas Board of Pharmacy. The following
information must be provided on each prescription:
(1) the patient’s name and address;
(2) the name, strength, and quantity of the drug to be dispensed;
(3) directions to the patient regarding taking of the drug and the dosage;
(4) the intended use of the drug, if appropriate;
(5) the name, address, telephone number, and, if the prescription is for a controlled
substance, the DEA number
of the delegating physician;
(6) address and telephone number of the site at which the prescription drug order
was carried out or signed;
(7) the date of issuance;
(8) the number of refills permitted; and
(9) the name, prescription authorization number, original signature, and, if the
prescription is for a controlled substance, the DEA number of the advanced practice
nurse signing or co-signing the prescription drug order.
(d) Generic Substitution. The advanced practice nurse shall authorize or prevent generic
substitution on a prescription in compliance with the current rules of the Texas State
Board of Pharmacy relating to Generic Substitution.
The provisions of this §222.4 adopted to be effective November 26, 2003, 28 TexReg 10502.
§222.5. Prescriptions for Dangerous Drugs
Advanced practice nurses with full or provisional authorization to practice and valid
prescription authorization numbers are eligible to carry out or sign prescription drugs
orders for dangerous drugs in accordance with the standards and requirements set forth
in this chapter.
The provisions of this §222.5 adopted to be effective November 26, 2003, 28 TexReg 10502.
§222.6. Prescriptions for Controlled Substances
(a) Advanced practice nurses with full authorization to practice and valid prescription
authorization numbers are eligible to prescribe certain categories of controlled
substances. Graduate advanced practice nurses who hold provisional authorization to
practice shall not authorize or issue prescriptions for controlled substances until they
have been issued full authorization to practice by the board.
(b) Advanced practice nurses with full authorization to practice and valid prescription
authorization numbers who authorize or issue prescriptions for controlled substances
shall:
(1) Limit prescriptions for controlled substances to those listed in Schedules III, IV, or
V as established by the commissioner of public health under Chapter 481, Health
and Safety Code (Texas Controlled Substances Act);
(2) Issue prescriptions for a period not to exceed 30 days;
(3) Not authorize the refill of a prescription for a controlled substance prior to
consultation with the delegating physician and notation of the consultation in the
patient’s chart; and
(4) Not authorize the prescription of a controlled substance for a child less than two
years of age prior to consultation with the delegating physician and notation of the
consultation in the patient’s chart.
131
(c) All other standards and requirements as set forth in this chapter relating to carrying
out or signing prescription drug orders by advanced practice nurses must be met. In
addition, advanced practice nurses with full authorization to practice and valid
prescription authorization numbers must comply with all federal, state and local laws and
regulations relating to the prescribing of controlled substances, including but not limited
to, requirements set forth by the Texas Department of Public Safety and the Drug
Enforcement Administration.
The provisions of this §222.6 adopted to be effective November 26, 2003, 28 TexReg 10502.
§222.7. Prescribing at Sites Serving Certain Medically Underserved Populations
When carrying out or signing prescription drug orders at a site serving a medically
underserved population, the advanced practice nurse shall:
(1) maintain Protocols or other written authorization that must be reviewed and
signed by both the advanced practice nurse and the delegating physician at least
annually;
(2) have access to the delegating physician or alternate delegating physician for
consultation, assistance with medical emergencies, or patient referral;
(3) provide a daily status report to the physician on any problems or complications
encountered that are not covered by protocol; and
(4) shall be available during on-site visits by the physician which shall occur at least
once every 10 business days that the advanced practice nurse is on site providing
care.
The provisions of this §222.7 adopted to be effective November 26, 2003, 28 TexReg 10502.
§222.8. Prescribing at Physicians’ Primary Practice Sites
When carrying out or signing prescription drug orders at a physician’s primary practice
site, the advanced practice nurse shall:
(1) maintain Protocols or other written authorization that must be reviewed and
signed by both the advanced practice nurse and the delegating physician at least
annually;
(2) sign or co-sign prescription drug orders only for those patients with whom the
physician has established or will establish a physician-patient relationship although
the physician is not required to see the patient within a specified time period.
The provisions of this §222.8 adopted to be effective November 26, 2003, 28 TexReg 10502.
§222.9. Prescribing at Alternate Sites
When carrying out or signing prescription drug orders at an alternate site, the advanced
practice nurse shall:
(1) maintain Protocols or other written authorization that must be reviewed and
signed by both the advanced practice nurse and the delegating physician at least
annually;
(2) be on-site with the physician at least twenty percent of the time; and
(3) have access to the physician through direct telecommunication for consultation,
patient referral, or assistance with a medical emergency;
The provisions of this §222.9 adopted to be effective November 26, 2003, 28 TexReg 10502.
132
§222.10. Prescribing at Facility-based Practice Sites
When carrying out or signing prescription drug orders at a facility-based practice site, the
advanced practice nurse shall:
(1) maintain Protocols or other written authorization developed in accordance with
facility medical staff policies and reviewing the authorizing documents with the
appropriate medical staff at least annually;
(2) sign or co-sign prescription drug orders in the facility in which the delegating
physician is the medical director, the chief of medical staff, the chair of the
credentialing committee, or a department chair; or a physician who
consents to the request of the medical director or chief of the medical staff to
delegate; and
(3) sign or co-sign prescription drug orders for the care or treatment of only those
patients for whom physicians have given their prior consent.
The provisions of this §222.10 adopted to be effective November 26, 2003, 28 TexReg 10502.
§222.11. Conditions for Obtaining and Distributing Drug Samples
The advanced practice nurse with a valid prescription authorization number may
request, receive, possess and distribute prescription drug samples provided:
(1) all requirements for the advanced practice nurse to sign prescription drug orders
are met;
(2) Protocols or other physician orders authorize the advanced practice nurse to sign
the prescription drug orders;
(3) the samples are for only those drugs that the advanced practice nurse is eligible
to prescribe in accordance with the standards and requirements set forth in this
chapter; and
(4) a record of the sample is maintained and samples are labeled as specified in the
Dangerous Drug Act (Health and Safety Code, Chapter 483) or the Controlled
Substances Act (Health and Safety Code, Chapter 481) and 37
Texas Administrative Code, Chapter 13.
The provisions of this §222.11 adopted to be effective November 26, 2003, 28 TexReg 10502.
§222.12. Enforcement
(a) Any nurse who violates these rules shall be subject to removal of the authority to
prescribe under this rule and disciplinary action by the board under Texas Occupations
Code §301.452.
(b) The board shall report to the Texas Department of Public Safety and the Drug
Enforcement Administration any of the following:
(1) Any significant changes in the status of the RN license/advanced practice
authorization, or
(2) Disciplinary action impacting an advanced practice nurse’s ability to authorize or
issue prescription drug orders.
(c) The practice of the advanced practice nurse approved by the board to carry out or
sign prescription drug orders is subject to monitoring by the board on a periodic basis.
The provisions of this §222.12 adopted to be effective November 26, 2003, 28 TexReg 10502.