By: Howard of Travis H.B. No. 4355

A BILL TO BE ENTITLED

AN ACT

relating to the conducting of a research study on alternate ways to assure clinical competency of graduates of nursing educational programs.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Chapter 105, Heath and Safety Code, is amended by adding Section 105.008 to read as follows:

Sec. 105.008. STUDY OF ALTERNATE WAYS TO ASSURE CLINICAL COMPETENCY OF GRADUATES OF NURSING EDUCATIONAL PROGRAMS.

(a) In this section:

(1) "Professional nursing prelicensure program" means a professional nursing educational program that prepares students for initial licensure as registered nurses.

(2) "Single clinical competency assessment program" means a professional nursing prelicensure program that has a single competency assessment at the end of the program to determine the competency in clinical judgment and behaviors of its graduates.

(3) "Study" means the study described under Subsection (b).

(4) "Supervised clinical learning experiences program" means a professional nursing prelicensure program that requires students to complete a required number of supervised clinical learning experiences provided by qualified clinical faculty involving multiple, ongoing assessments and feedback.

(b) To the extent funding is available, the nursing resource section established under Section 105.002(b) shall design and conduct a study to:

(1) identify a set of expected student outcomes in terms of clinical judgment and behaviors that professional nursing students should possess upon graduation from a professional nursing prelicensure program;

(2) identify standardized clinical exit evaluation tools that could be used to evaluate the competencies of clinical judgment and behaviors that professional nursing students possess upon graduation from a professional nursing prelicensure program;

(3) identify any correlation between the success rate of graduates of professional nursing prelicensure programs on standardized clinical exit evaluation tools and their educational and experiential background including:

(A) length and type of healthcare work experience prior to entering into the professional nursing prelicensure programs;

(B) healthcare work experience during the educational program; and

(C) alternate ways to teach clinical judgment and behaviors such as supervised clinicals and simulation laboratories.

(c) (1) In addition to any other objective, the study shall be designed to specifically answer the question whether the nursing graduates of a single clinical competency assessment program are able after graduation to practice in a clinical setting at a level substantially equivalent to the graduates of a supervised clinical learning experiences program if the single clinical competency assessment program is one that:

(A) has been requiring only a single clinical competency assessment for at least 10 years;

(B) has students who reside in this state;

(C) has graduates who have been considered by the board to be eligible to apply for a registered nurse license as a result of graduating from the program on or before January 1, 2007; and

(D) conducts the single clinical competency assessment at a facility located in this state under the supervision of a registered nurse who holds a master's or doctoral degree in nursing and who has at least five years of experience on the faculty of a nursing program approved to operate in this state.

(2) Considerations to be used by the nursing resource section in determining substantial equivalence under Subdivision (1) shall include differences between the single competency assessment program and the supervised clinical learning experience program in:

(A) the methods of evaluating students' clinical judgment and behaviors;

(B) performance on standardized clinical exit evaluation tools;

(C) the ability of graduates to transition and assimilate in the registered nurse's role; and

(D) pass rates on the NCLEX licensure exam.

(d) The nursing resource section shall complete the study not later than June 30, 2014.

(e) The nursing resource center may contract with a third party to conduct the study.

(f) The nurses resource section may partner with the Texas Board of Nursing and the Texas Higher Education Coordinating Board in conducting the study.

(g) The committee formed under Section 104.0155 shall serve as the oversight committee for the study or may appoint a special committee to provide the oversight.

(h) Any data collected as part of the study that contains information identifying specific students, patients or health care facilities is confidential, is not subject to disclosure under Chapter 552, Government Code, and may not be released unless all identifying information is removed.

(i) (1) In addition to funds appropriated by the legislature, the nursing resource section may solicit, receive, and spend grants, gifts, and donations from public or private sources for the purposes of conducting the study.

(2) If grants funds are available through the National Council of State Boards of Nursing that could be used to fund the study, the nursing resource section shall apply for such funds to the maximum amount available up to the estimated costs of the study. In making the application, the nursing resource section shall not relinquish any oversight responsibility for the study.

(j) If the study finds that graduates of a nursing educational program that requires students to pass only a single clinical competency assessment are not able after graduation to practice in a clinical setting at a level substantially equivalent to the graduates of a nursing educational program that requires students to complete a required number of supervised clinical learning experiences, the Texas Board of Nursing shall allow a program participating in the study to modify its program, not later than December 31, 2017, to meet any standards required for graduates of the program to be eligible to apply to the board for a license. The board may not disqualify graduates of a program that is modifying its program under this subsection from receiving a license under Chapter 301, Occupations Code before December 31, 2017.

(k) If funding is not available to conduct the study, the Texas Board of Nursing shall allow graduates of a single clinical competency assessment program that meets the criteria set out in Subsection (c)(1) to be eligible to apply to the board for a license until December 31, 2017.

SECTION 2. Section 301.155(c), Occupations Code, is amended to read as follows:

(c) The board shall assess a [$3] surcharge for a registered nurse of at least $3 and not more than $5 and a [$2] surcharge for a vocational nurse of at least $2 and not more than $3 to the fee established by the board under Subsection (a) for a license holder to renew a license under this chapter. The board may use nine cents of the registered nurse surcharge and six cents of the vocational nurse surcharge to cover the administrative costs of collecting and depositing the surcharge. The board quarterly shall transmit the remainder of each surcharge to the Department of State Health Services to be used only to implement the nursing resource section under Section 105.002, Health and Safety Code. The board is not required to collect the surcharge if the board determines the funds collected are not appropriated for the purpose of funding the nursing resource section.

SECTION 3. Section 63.002(f), Education Code is amended to read as follows:

(f) Notwithstanding the limitation provided by Subsection (b), grants awarded under Subsection (c) for the state fiscal biennium ending on August 31, 2009, and the fiscal biennium ending on August 31, 2011, by the Texas Higher Education Coordinating Board shall be awarded to programs preparing students for initial licensure as registered nurses or programs preparing qualified faculty members with a master's or doctoral degree for the program, including programs at two-year institutions of higher education, four-year general academic teaching institutions, health science centers, and independent or private institutions of higher education or the nursing resource section established under Section 105.002(b), Health and Safety Code. In awarding grants under this subsection, the coordinating board may:

(1) give priority to institutions proposing to address the shortage of registered nurses by promoting innovation in education, recruitment, and retention of nursing students and qualified faculty;

(2) award grants on a competitive basis; [and]

(3) consider the availability of matching funds and

(4) fund a study by the nursing resource section to evaluate the competencies of clinical judgment and behaviors that professional nursing students should possess upon graduation.

SECTION 4. This Act takes effect immediately if it receives a vote of two-thirds of all the members elected to each house, as provided by Section 39, Article III, Texas Constitution. If this Act does not receive the vote necessary for immediate effect, this Act takes effect September 1, 2009.