MODULE 1
1. What are the BON rules and regulations for prescriptive authority for the
advance practice nurse?
Prescriptive authority is the legal right to prescribe drugs. Full prescriptive authority
affords the legal right to prescribe independently and without limitation.
Limitations are generally tied to oversight by a doctor of medicine (MD) or doctor of
osteopathy (DO) as part of the provider's scope of practice. Recall that there are two
components of prescriptive authority: (1) the right to prescribe independently and (2) the
right to prescribe without limitation. The provider who prescribes independently is not
subject to rules requiring physician supervision or collaboration. The provider who
prescribes without limitation may prescribe any drugs, including controlled drugs, with
the exception of Schedule I drugs which have no current medical use.
APRNs are educated to practice and prescribe independently without supervision;
however, some state laws require that they practice in collaboration with or under the
supervision of a physician. In these situations, some physicians limit the types of drugs
that the APRN can prescribe. State laws may place additional restrictions with regard to
controlled drugs.
The possession of full prescriptive authority requires a somber responsibility. Whether
you are reading this book as a student or as a practicing provider, it is essential to
recognize the full obligation this requires. The safe and competent practice of
prescribing and managing medications requires a sound understanding of drugs and the
conditions that they are used to manage.
Application Forms - Advanced Practice Registered
Nurse
The fastest way to become licensed as an advanced practice registered nurse (APRN)
in Texas is to submit all of the required documents together. Applications that are
complete, correct and are received with all the required documents needed for licensure
are expedited. If any of the information on your application is incorrect, incomplete or
illegible, review of the application may be delayed. During graduation season, the
volume increases exponentially and we sometimes experience delays. Our resources
are limited and we are reviewing applications as quickly as possible. The 30 day
timeline referred to on the website is an internal timeframe we attempt to meet when
possible. We truly appreciate your patience with the review process.
Requirements for Texas APRN Licensure - With Optional Prescriptive
Authority
,MODULE 1
Required fee is $100 for APRN licensure only. If you are requesting APRN
licensure with prescriptive authority, the required fee is $150. This fee is
nonrefundable.
Texas RN licensure or RN licensure with compact privilege from a state that is
party to the Nurse Licensure Compact for RNs and LVNs.
Completion of an advanced practice nursing educational program accredited by
an organization recognized by the Board that complies with the requirements
in Rule 221.3 (see below).
National certification in the role and population focus area congruent with your
advanced practice nursing educational preparation. The expiration date of the
certification will be requested. If the certification expires more than four years
from today, leave the certification expiration date blank and fax copies of the
certification, to the Boards office (512) 305-7401 - Attn: APRN Office, upon
completion of the online application.
Completion of a minimum of 400 hours of practice in your advanced practice role
and population focus area within the last 24 calendar months or completion of
your advanced practice nursing educational program within the last 24 calendar
months
Completion of a minimum of 20 contact hours of continuing nursing education in
your advanced role and population focus area within the last 24 calendar months
or completion of your advanced practice nursing educational program with the
last 24 calendar months.
Educational Requirements:
If you completed your program on or after January 1, 1998, you must demonstrate that
you have completed separate, dedicated courses in the following subject areas:
Advanced Physical Assessment that includes a clinical component
Pathophysiology
Pharmacotherapeutics
APRN Role Preparation
Clinical major courses targeted for your advanced practice role and population
focus area
Completion of a practicum/preceptorship/internship within your advanced
practice nursing educational program that provided the opportunity to provide
direct advanced practice patient care and management under the
guidance/supervision of faculty and qualified clinical preceptors
If you completed your program on or after January 1, 2003, your program must have
included a minimum of 500 hours of separate, non-duplicated clinical hours in each
advanced practice role and population focus area within the advanced practice nursing
educational program.
Educational Requirements:
,MODULE 1
If you completed your program on or after January 1, 1998, you must demonstrate that
you have completed separate, dedicated courses in the following subject areas:
Advanced Physical Assessment that includes a clinical component
Pathophysiology
Pharmacotherapeutics
APRN Role Preparation
Clinical major courses targeted for your advanced practice role and population
focus area
Completion of a practicum/preceptorship/internship within your advanced
practice nursing educational program that provided the opportunity to provide
direct advanced practice patient care and management under the
guidance/supervision of faculty and qualified clinical preceptors
If you completed your program on or after January 1, 2003, your program must have
included a minimum of 500 hours of separate, non-duplicated clinical hours in each
advanced practice role and population focus area within the advanced practice nursing
educational program.
An APRN who has been issued full licensure and a valid prescription authorization
number by the Board may order or prescribe non-prescription drugs, dangerous drugs,
and devices, including durable medical equipment, in accordance with the standards
and requirements set forth in this chapter. However, if the APRN wishes to also order or
prescribe controlled substances, the APRN must also meet the additional requirements
of §222.8 (relating to Authority to Order and Prescribe Controlled Substances) of this
chapter.
(a) APRNs with full licensure and a valid prescription authorization number are eligible
to obtain authority to order and prescribe certain categories of controlled substances.
The APRN must comply with all federal and state laws and regulations relating to the
ordering and prescribing of controlled substances in Texas, including but not limited to,
requirements set forth by the United States Drug Enforcement Administration.
, MODULE 1
(b) Orders and prescriptions for controlled substances in Schedules III through V may
be authorized, provided the following criteria are met:
(1) Prescriptions for a controlled substance in Schedules III through V, including a refill
of the prescription, shall not exceed a 90-day supply. This requirement includes a
prescription, either in the form of a new prescription or in the form of a refill, for the
same controlled substance that a patient has been previously issued within the time
period described by this subsection.
(2) Beyond the initial 90 days, the refill of a prescription for a controlled substance in
Schedules III through V shall not be authorized prior to consultation with the delegating
physician and notation of the consultation in the patient's chart.
(3) A prescription of a controlled substance in Schedules III through V shall not be
authorized 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.
(c) Orders and prescriptions for controlled substances in Schedule II may be authorized
only:
(1) in a hospital facility-based practice, in accordance with policies approved by the
hospital's medical staff or a committee of the hospital's medical staff as provided by the
hospital's bylaws to ensure patient safety and as part of care provided to a patient who:
(A) has been admitted to the hospital for an intended length of stay of 24 hours or
greater; or
(B) is receiving services in the emergency department of the hospital; or
(2) as part of the plan of care for the treatment of a person who has executed a written
certification of a terminal illness, has elected to receive hospice care, and is receiving
hospice treatment from a qualified hospice provider.
(d) Prescription Monitoring Program (PMP).
(1) APRNs should access and review the prescription monitoring program (PMP)
authorized by Chapter 481, Health and Safety Code, prior to prescribing any controlled
substance for patients being treated for pain.
(2) APRNs must access and review the PMP before prescribing opioids,
benzodiazepines, barbiturates, or carisoprodol unless:
(A) the patient has been diagnosed with cancer or the patient is receiving hospice
care; and
1. What are the BON rules and regulations for prescriptive authority for the
advance practice nurse?
Prescriptive authority is the legal right to prescribe drugs. Full prescriptive authority
affords the legal right to prescribe independently and without limitation.
Limitations are generally tied to oversight by a doctor of medicine (MD) or doctor of
osteopathy (DO) as part of the provider's scope of practice. Recall that there are two
components of prescriptive authority: (1) the right to prescribe independently and (2) the
right to prescribe without limitation. The provider who prescribes independently is not
subject to rules requiring physician supervision or collaboration. The provider who
prescribes without limitation may prescribe any drugs, including controlled drugs, with
the exception of Schedule I drugs which have no current medical use.
APRNs are educated to practice and prescribe independently without supervision;
however, some state laws require that they practice in collaboration with or under the
supervision of a physician. In these situations, some physicians limit the types of drugs
that the APRN can prescribe. State laws may place additional restrictions with regard to
controlled drugs.
The possession of full prescriptive authority requires a somber responsibility. Whether
you are reading this book as a student or as a practicing provider, it is essential to
recognize the full obligation this requires. The safe and competent practice of
prescribing and managing medications requires a sound understanding of drugs and the
conditions that they are used to manage.
Application Forms - Advanced Practice Registered
Nurse
The fastest way to become licensed as an advanced practice registered nurse (APRN)
in Texas is to submit all of the required documents together. Applications that are
complete, correct and are received with all the required documents needed for licensure
are expedited. If any of the information on your application is incorrect, incomplete or
illegible, review of the application may be delayed. During graduation season, the
volume increases exponentially and we sometimes experience delays. Our resources
are limited and we are reviewing applications as quickly as possible. The 30 day
timeline referred to on the website is an internal timeframe we attempt to meet when
possible. We truly appreciate your patience with the review process.
Requirements for Texas APRN Licensure - With Optional Prescriptive
Authority
,MODULE 1
Required fee is $100 for APRN licensure only. If you are requesting APRN
licensure with prescriptive authority, the required fee is $150. This fee is
nonrefundable.
Texas RN licensure or RN licensure with compact privilege from a state that is
party to the Nurse Licensure Compact for RNs and LVNs.
Completion of an advanced practice nursing educational program accredited by
an organization recognized by the Board that complies with the requirements
in Rule 221.3 (see below).
National certification in the role and population focus area congruent with your
advanced practice nursing educational preparation. The expiration date of the
certification will be requested. If the certification expires more than four years
from today, leave the certification expiration date blank and fax copies of the
certification, to the Boards office (512) 305-7401 - Attn: APRN Office, upon
completion of the online application.
Completion of a minimum of 400 hours of practice in your advanced practice role
and population focus area within the last 24 calendar months or completion of
your advanced practice nursing educational program within the last 24 calendar
months
Completion of a minimum of 20 contact hours of continuing nursing education in
your advanced role and population focus area within the last 24 calendar months
or completion of your advanced practice nursing educational program with the
last 24 calendar months.
Educational Requirements:
If you completed your program on or after January 1, 1998, you must demonstrate that
you have completed separate, dedicated courses in the following subject areas:
Advanced Physical Assessment that includes a clinical component
Pathophysiology
Pharmacotherapeutics
APRN Role Preparation
Clinical major courses targeted for your advanced practice role and population
focus area
Completion of a practicum/preceptorship/internship within your advanced
practice nursing educational program that provided the opportunity to provide
direct advanced practice patient care and management under the
guidance/supervision of faculty and qualified clinical preceptors
If you completed your program on or after January 1, 2003, your program must have
included a minimum of 500 hours of separate, non-duplicated clinical hours in each
advanced practice role and population focus area within the advanced practice nursing
educational program.
Educational Requirements:
,MODULE 1
If you completed your program on or after January 1, 1998, you must demonstrate that
you have completed separate, dedicated courses in the following subject areas:
Advanced Physical Assessment that includes a clinical component
Pathophysiology
Pharmacotherapeutics
APRN Role Preparation
Clinical major courses targeted for your advanced practice role and population
focus area
Completion of a practicum/preceptorship/internship within your advanced
practice nursing educational program that provided the opportunity to provide
direct advanced practice patient care and management under the
guidance/supervision of faculty and qualified clinical preceptors
If you completed your program on or after January 1, 2003, your program must have
included a minimum of 500 hours of separate, non-duplicated clinical hours in each
advanced practice role and population focus area within the advanced practice nursing
educational program.
An APRN who has been issued full licensure and a valid prescription authorization
number by the Board may order or prescribe non-prescription drugs, dangerous drugs,
and devices, including durable medical equipment, in accordance with the standards
and requirements set forth in this chapter. However, if the APRN wishes to also order or
prescribe controlled substances, the APRN must also meet the additional requirements
of §222.8 (relating to Authority to Order and Prescribe Controlled Substances) of this
chapter.
(a) APRNs with full licensure and a valid prescription authorization number are eligible
to obtain authority to order and prescribe certain categories of controlled substances.
The APRN must comply with all federal and state laws and regulations relating to the
ordering and prescribing of controlled substances in Texas, including but not limited to,
requirements set forth by the United States Drug Enforcement Administration.
, MODULE 1
(b) Orders and prescriptions for controlled substances in Schedules III through V may
be authorized, provided the following criteria are met:
(1) Prescriptions for a controlled substance in Schedules III through V, including a refill
of the prescription, shall not exceed a 90-day supply. This requirement includes a
prescription, either in the form of a new prescription or in the form of a refill, for the
same controlled substance that a patient has been previously issued within the time
period described by this subsection.
(2) Beyond the initial 90 days, the refill of a prescription for a controlled substance in
Schedules III through V shall not be authorized prior to consultation with the delegating
physician and notation of the consultation in the patient's chart.
(3) A prescription of a controlled substance in Schedules III through V shall not be
authorized 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.
(c) Orders and prescriptions for controlled substances in Schedule II may be authorized
only:
(1) in a hospital facility-based practice, in accordance with policies approved by the
hospital's medical staff or a committee of the hospital's medical staff as provided by the
hospital's bylaws to ensure patient safety and as part of care provided to a patient who:
(A) has been admitted to the hospital for an intended length of stay of 24 hours or
greater; or
(B) is receiving services in the emergency department of the hospital; or
(2) as part of the plan of care for the treatment of a person who has executed a written
certification of a terminal illness, has elected to receive hospice care, and is receiving
hospice treatment from a qualified hospice provider.
(d) Prescription Monitoring Program (PMP).
(1) APRNs should access and review the prescription monitoring program (PMP)
authorized by Chapter 481, Health and Safety Code, prior to prescribing any controlled
substance for patients being treated for pain.
(2) APRNs must access and review the PMP before prescribing opioids,
benzodiazepines, barbiturates, or carisoprodol unless:
(A) the patient has been diagnosed with cancer or the patient is receiving hospice
care; and
