(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.
  (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.

Source Note: The provisions of this §221.13 adopted to be effective February 25, 2001, 26 TexReg 1509