Nursing requires lifelong learning and the continuing competency process allows the nurse to continue to grow professionally. A nurse may choose among two methods of demonstrating continuing competency for each two-year licensing period. A nurse may complete 20 contact hours of continuing nursing education (CNE) in the nurse’s current area of practice; OR achieve, maintain, or renew an approved national nursing certification in the nurse’s current area of practice. Additionally, if a nurse chooses to complete 20 contact hours of CNE as the method for demonstrating continuing competency, the nurse may choose from multiple methods for acquiring those CNE contact hours including: academic courses, program development and/or presentation, and authorship
Forensic Evidence Collection
Board Rule 216.3(d)
Any nurse who is employed in an emergency room (ER) setting, including any nurse who could float to an ER or have shifts scheduled in an ER, as well as any nurse employed under contractual, temporary, per diem, agency, traveling, or another employment relationship whose duties include working in an ER must complete at least 2 contact hours of CNE relevant to forensic evidence collection and age- or population-specific nursing interventions that may be required by other laws and/or are necessary in order to assure evidence collection that meets requirements under the Government Code §420.031 regarding use of an Attorney General-approved evidence collection kit and protocol.
Content may also include documentation, history-taking skills, use of sexual assault kit, survivor symptoms, and emotional and psychological support interventions for victims.
This is a one-time requirement within two years of the initial date of the nurse’s employment in an ER setting. (Maintain record of course completion indefinitely, even if you change employment.)
Any nurse who performs a forensic examination on a sexual assault survivor must complete basic forensic evidence collection training or the equivalent education prior to performing the exam.
This is a one-time requirement. (Maintain record of course completion indefinitely, even if you change employment.)
Contact hours completed for this requirement do count towards completion of the 20 contact hours of CNE required for all nurses.
Board-approved certification related to forensic evidence collection may be used to fulfill this requirement.
APRNs may use CME in forensic evidence collection that is approved by the Texas Medical Board to fulfill this requirement.
Older Adult or Geriatric Care
Board Rule 216.3(h)
Any nurse whose practice includes older adult or geriatric populations is required to complete at least 2 contact hours of CNE relating to older adult or geriatric populations before the end of every licensing period (applicable to licensing periods that began on or after January 1, 2014).
The CNE course(s) may contain information related to:
elder abuse,
age-related memory changes and disease processes
(including chronic conditions),
end of life issues,
health maintenance, and
health promotion.
Contact hours completed for this requirement do count towards completion of the 20 contact hours of CNE required for all nurses.
Board-approved certification related to older adult or geriatric populations may be used to fulfill this requirement.
APRNs may use Category I CME to fulfill this requirement.
Nursing Jurisprudence and Nursing Ethics
Board Rule 216.3(g)
All nurses must complete at least 2 contact hours of CNE relating to nursing jurisprudence and nursing ethics before the end of every third two-year licensing period (applicable to licensing periods that began on or after January 1, 2014).
The CNE course(s) must contain information related to:
• the Texas Nursing Practice Act,
• the Board’s rules (including §217.11, Standards of Nursing Practice),
• the Board’s position statements,
• principles of nursing ethics, and
• professional boundaries.
Contact hours completed for this requirement do count towards completion of the 20 contact hours of CNE required for all nurses.
Certification may not be used to fulfill this requirement.
APRNs may not use CME to fulfill this requirement. Only CNE is acceptable.
*Please click here to see examples illustrating how to determine when you need to complete this requirement based upon your birth month and year and licensure date (found on page 9).
Pharmacotherapeutics
Board Rule 216.3©(3)
Any APRN who holds prescriptive authority must complete at least 5 additional contact hours of continuing education in pharmacotherapeutics before the end of every licensing period.
These hours are in addition to the 20 contact hours required for all nurses.
Certification may not be used to fulfill this requirement.
Category I CME may be used to fulfill this requirement.
Pain Management and Prescription of Opioids
Board Rule 216.3©(4)
Any APRN who has entered into a prescriptive authority agreement authorizing the prescribing of opioids must complete not less than 2 hours of continuing education annually (meaning, 4 hours every licensing period) regarding safe and effective pain management related to the prescription of opioids and other controlled substances, including education regarding:
• reasonable standards of care;
• the identification of drug-seeking behavior in patients; and
• effectively communicating with patients regarding the prescription of an opioid or other controlled substance
before the end of every licensing period (applicable to licensure renewals on or after January 1, 2021).
Contact hours completed for this requirement do count towards completion of the 20 contact hours of CNE required for all nurses.
Certification may not be used to fulfill this requirement.
Category I CME may be used to fulfill this requirement.
Background: As a result of the 2019 Texas Legislative session, House Bill (HB) 2454 was passed, amending Section 157.0513(a) of the Texas Occupations Code, among other things, effective September 1, 2019. This is the bill responsible for this Pain Management and Prescription of Opioids CE requirement for select APRNs. You can read the final copy of HB 2454 by clicking here.
Authorization to receive information from the Texas Prescription Monitoring Program (PMP)
Board Rule 216.3©(6)
Any APRN licensed prior to September 1, 2020, and authorized to receive information from the PMP must complete 2 hours of continuing education related to approved procedures of prescribing and monitoring controlled substances no later than September 1, 2021.
Any APRN licensed after September 1, 2020, and authorized to receive information from the PMP must complete 2 hours of continuing education related to approved procedures of prescribing and monitoring controlled substances no later than 1 year after the APRN’s initial licensure date.
This is a time-limited requirement.
Contact hours completed for this requirement do count towards completion of the 20 contact hours of CNE required for all nurses.
Certification may not be used to fulfill this requirement.
Category I CME may be used to fulfill this requirement.
Background: As a result of the 2019 Texas Legislative session, House Bill (HB) 2174 was passed, adding Sections 481.07635 and 481.07636 to the Texas Health and Safety Code, among other things, effective September 1, 2019. This is the bill responsible for this PMP-related CE requirement for select APRNs. You can read the final copy of HB 2174 by clicking here.
Human Trafficking Prevention
Board Rule 216.3(i)
Any nurse who provides direct patient care must complete a human trafficking prevention course that is approved by the Executive Director of Texas Health and Human Services Commission (HHSC) that covers identifying and assisting victims of human trafficking before the end of every licensing period (applicable to licensure renewals on or after September 1, 2020).
More information regarding Health Care Practitioner Human Trafficking Training is available as part of the HHSC’s Texas Human Trafficking Resource Center here.
View the list of currently approved human trafficking prevention courses (PDF).
NOTE: In March 2025, HHSC revised standards for reviewing human trafficking training courses. View the revised HHSC Human Trafficking Training Standards (PDF). HHSC is currently reviewing all courses, including previously approved courses, according to the new training standards.
Email
HHSC Human Trafficking with any questions.
CNE contact hours completed for this requirement may count towards completion of the 20 contact hours of
CNE required for all nurses.
Certification may not be used to fulfill this requirement; an HHSC-approved course, as described above, must be completed.
APRNs may use Category I CME from an approved course towards renewal.
Background: House Bill (HB) 2059 is responsible for the Human Trafficking Prevention CE requirement for select nurses. This bill was passed during the 2019 Texas Legislative session; adding Sections 116.002 and 301.308, among others, to the Texas Occupations Code. As a result of HB 2059 HHSC will adopt rules to implement Texas Occupations Code Chapter 116, a new chapter being added to the Texas Occupations Code, effective September 1, 2019. This bill also requires HHSC to approve training courses on human trafficking, including at least one that is free of charge, post the list of approved trainings on the HHSC website, and update the list of approved trainings as necessary. You can read the final copy of HB 2059 by clicking here.
Tick-Borne Diseases
Board Rule 216.3(f)
Any APRN whose practice includes the treatment of tick-borne diseases is encouraged to participate in continuing education relating to the treatment of tick-borne diseases.
The continuing education course(s) should contain information relevant to treatment of the disease within the APRN’s role and population focus area of licensure and may represent a spectrum of relevant medical clinical treatment relating to tick-borne disease.
Contact hours completed for this requirement do count towards completion of the 20 contact hours of CNE required for all nurses.
Certification may not be used to fulfill this requirement.
Category I CME in the treatment of tick-borne disease may be used to fulfill this requirement.
