Reviewing the Rules: The Texas Board of Nursing Reviews its Rules. Part 2 of 3: Rule 224 – Unlicensed Assistive Personnel in Acute Care Settings

Regulatory agencies in Texas are required to review the rules governing their areas of responsibility every four years.  In December, the Board filed the results of its review of three rules – none are the biggest rules, but important in some respects.
The second rule reviewed is probably the rule that creates the most controversy in the Emergency Department setting because of the relatively independent pre-hospital practice of paramedics.  Often, paramedics come and work in the ED and expect to be able to do many of the same skills as in the field.  But under the Board of Nursing rules, this is delegation to unlicensed assistive personnel (UAP) and fall under the delegation rules. However, the rule does not preclude a nurse from delegating some skill tasks to a UAP.  This is a facility decision, not a Board of Nursing mandate.

I will have to post on the rules associated with UAP’s in the near future.  The text of the notice of review is after the jump:

Texas Board of Nursing

Title 22, Part 11

The Texas Board of Nursing (Board) filed a notice of intent to review and consider for readoption, revision, or repeal 22 Texas Administrative Code Chapter 224, relating to Delegation of Nursing Tasks by Registered Professional Nurses to Unlicensed Personnel for Clients with Acute Conditions or in Acute Care Environments. The Notice of Intent to Review was published in the October 28, 2011, issue of the Texas Register (36 TexReg 7369).

The Government Code §2001.039 requires each state agency to review its rules every four years to determine if the reasons for initially adopting the rules continue to exist. The rules in Chapter 224 were scheduled for this four-year review. No comments were received concerning the Board’s proposed rule review.

The Board has completed its review of the rules in Chapter 224 and has determined that the reasons for originally adopting these rules continue to exist. The rules were also reviewed to determine whether they were obsolete, whether they reflected current legal and policy considerations and current procedures and practices of the Board, and whether they were in compliance with the Government Code Chapter 2001 (Administrative Procedure Act).

The Board re-adopts the rules in Chapter 224 without changes, pursuant to the Government Code §2001.039 and the Occupations Code §301.151, which authorizes the Board to adopt, enforce, and repeal rules consistent with its legislative authority under the Nursing Practice Act. This concludes the rule review of Chapter 224 under the implementation of the Board’s rule review plan for 2011-2013 that is published on the Secretary of State’s website.


Lance Brenton

Assistant General Counsel

Texas Board of Nursing

Filed: December 8, 2011

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