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RULE §226.4Limited Exception to Mandatory Reporting Requirements

(a) In approving a pilot program, the Board may grant a program an exception to the mandatory reporting requirements of sections 301.401-301.409 or to a rule adopted under chapters 301 or 303 that relate to the practice of professional nursing, including education and reporting requirements for registered nurses.

(b) The Board may not grant the exception to:

  (1) the education requirements of sections 301.303 through 301.304 unless the program includes alternative but substantially equivalent requirements; or

  (2) the mandatory requirements sections 301.401-301.409 or to a rule adopted under chapters 301 or 303 unless the program:

    (A) is designed to evaluate the efficiency of alternative reporting methods; and

    (B) provides consumers adequate protection from registered nurses whose practice is a threat to public safety.

(c) To be eligible for an exception to mandatory reporting Sections 301.401-301.409 or to a rule adopted under Chapter 301 or Chapter 303 and in addition to the General Selection Criteria of §226.3, a pilot program must provide a replacement methodology designed to promote patient safety consistent with the exception requested. The criteria shall also be based on the ability of the patient safety pilot program to provide a framework for addressing the following issues:

  (1) Provide for the remediation of the deficiencies of a registered nurse who has knowledge or skill deficiencies that unless corrected may result in an unreasonable risk to public safety;

  (2) Provide for supervision of the nurse during remediation of deficiencies under paragraph (1); and

  (3) Require reporting to the Board of a registered nurse:

    (A) Who fails to satisfactorily complete remediation or who does not make satisfactory progress in remediation, under paragraph (1);

    (B) Whose incompetence in the practice of professional nursing would pose a continued risk of harm to the public; or

    (C) Whose error contributed to a patient death or serious patient injury.

  (4) Provide for a nursing peer review committee or other acceptable pilot committee to review whether a registered nurse is appropriate for remediation under paragraph (1).

Source Note: The provisions of this §226.4 adopted to be effective December 29, 2003, 28 TexReg 11587

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