Education - Continuing Nursing Education & Competency
For information regarding continuing education activities offered by the Texas Board of Nursing, please visit the CNE Course Catalog.
For questions regarding Continuing Competency, please review: Continuing Competency FAQs.
All nurses with an active Texas license are required to demonstrate continuing competency for relicensure. This aligns with the mission of the Board of Nursing (BON or Board) to protect and promote the welfare of the people of Texas by ensuring that each person holding a license as a nurse in the State of Texas is competent to practice safely.
In 1991, rules were adopted requiring nurses to complete 20 contact hours of continuing nursing education (CNE) every two years for relicensure. CNE is defined as programs beyond the basic nursing preparation that are designed to promote and enrich knowledge, improve skills, and develop attitudes for the enhancement of nursing practice, thus improving health care to the public [Board Rule 216.1(12)]. In 2009, rules were adopted to allow nurses to demonstrate competency through achievement of an approved national nursing certification in the nurse’s area of practice or completion of 20 contact hours of CNE. In 2010, the rules were changed requiring that the CNE be relevant to the nurse’s “area of practice.” “Area of practice” is defined as including any activity, assignment, or task performed by the nurse that utilizes nursing knowledge, judgement, or skills [Board Rule 216.1(4)]. Each nurse reactivating an inactive or delinquent license must also submit verification of 20 contact hours completed in the two years prior to reactivation, or have a current approved national nursing certification. If the nurse does not have a current area of practice, the nurse refers to the prior area of practice [Board Rule 216.1(4)].
One method to demonstrate compliance with the continuing competency requirements is to complete 20 contact hours of CNE in the nurse’s area of practice every two years coinciding with the nurse’s license renewal [Board Rule 216.3(a)]. A contact hour is defined as 60 minutes of a clock hour [Board Rule 216.1(11)]. The CNE hours must be earned within the two-year period immediately preceding the license renewal, beginning with the first day after the renewal month until the last day of the subsequent renewal. For example, if a nurse is required to renew the nursing license in December 2015 (his/her birth month), then the CNE hours must be earned between January 1, 2014 and December 31, 2015. Additional hours earned may not be carried over to the next renewal period.
Mandatory CNE Requirements
There are several mandatory continuing education requirements that nurses must meet. These requirements are detailed in this section. A nurse is required to retain continuing competency records for three licensure renewal cycles at a minimum [Board Rule 216.7 (c)].
Nursing Jurisprudence and Nursing Ethics. All licensed vocational nurses (LVNs), registered nurses (RNs), and advanced practice registered nurses (APRNs) are required to complete at least two contact hours of CNE in nursing jurisprudence and ethics prior to the end of each third two-year licensure renewal cycle for licensure cycles beginning on or after January 1, 2014. The course is required to contain information related to the Texas Nursing Practice Act, Texas BON Rules, Texas BON Position Statements, principles of nursing ethics, and professional boundaries [Board Rule 216.3(g)]. This course counts as part of the 20 required contact hours; however, certification cannot be used to fulfill this mandatory requirement [Board Rule 216.3(g)].
Older Adult or Geriatric Care. Any LVN, RN, or APRN whose practice includes the older adult or geriatric population is required to complete at least two contact hours in every licensure cycle beginning on or after January 1, 2014 [Board Rule 216.3(h)]. The content must include information relating to elder abuse, age related memory changes and disease processes, including chronic conditions, and end of life issues [Board Rule 216.3(h)(1)]. A nurse may choose to complete more than one course in order to cover all content required in the rule.
Forensic Evidence Collection CNE. Effective September 1, 2013, nurses who perform a forensic exam on a sexual assault survivor must have completed basic forensic evidence collection training, or the equivalent education, prior to performing the examination [Board Rule 216.3(d)(1)]. This is a one-time requirement; therefore, nurses who perform forensic exams are encouraged to retain the certificate of course completion indefinitely.
Effective September 1, 2005, the NPA was amended, adding the CNE requirement: Forensic Evidence Collection in Continuing Education. This targeted CNE requirement applies to all nurses practicing in emergency department (ED) settings as their home unit, floating, contracted, or other duties that involve functioning in an ED setting or role. This is a one-time requirement per nurse effective September 1, 2006. Any nurse who is working in an ED setting must complete this requirement within two years of the initial date of the nurse’s employment in an ED setting [Board Rule 216.3(d)(2)]. There is no expiration date for this requirement under Texas Occupations Code Section 301.306 (NPA); thus, any nurse working in the ED must comply and maintain the course completion certificate indefinitely.
What CNE is Acceptable?
To count toward licensure renewal, a program must have been approved by one of the credentialing agencies recognized by the Board. The credentialing agencies have met nationally-predetermined criteria to approve programs and providers of CNE. The Board recognizes the following credentialing agencies and providers:
Some of these organizations, in turn, approve other CNE providers. For example, most of the state nursing associations such as the Texas Nurses Association (TNA), and many of the nursing specialty organizations are accredited through the ANCC to approve both individual CNE programs and also approve providers of CNE programs. Thus, these programs would be accepted. In addition, the Board also recognizes the Licensed Vocational Nurses Association of Texas (LVNAT) and the Texas League of Vocational Nurses (TLVN) as providers of CNE.
PLEASE NOTE: Successful completion of either initial or renewal courses such as Advanced Cardiac Life Support, Advanced Trauma Life Support, Pediatric Advanced Life Support, and other courses specific to specialty practice, may be counted for CNE credit, if a specific course meets requirements of Chapter 216. If you are asked for proof of continuing competency, please submit the course completion certificate that meets the Board’s CNE criteria [please see Board Rule 216.4]. Cards from these courses are not accepted for CNE.
Self-Paced/Online CNE Programs are acceptable for CNE credit if approved by one of the credentialing organizations recognized by the BON (provided they meet any other criteria specified in Chapter 216).
What Certifications are Acceptable?
One method to demonstrate compliance with the continuing competency requirements is to attain, maintain or renew an approved national nursing certification in the nurse’s area of practice [Board Rule 216.3(b)]. A certification must be in nursing and have the approval of a national certification accreditation agency recognized by the Board to qualify as continuing competency for licensure renewal. A national nursing certification that has been approved by the Accreditation Board for Specialty Nursing Certification (ABSNC), that is attained, maintained or renewed during the licensure renewal cycle and is in the nurse’s area of practice, is acceptable to demonstrate the nurse’s continued competence.
The National Commission for Certifying Agencies (NCCA) is another certification accreditation agency; however, most of these certifications are not accepted since not all of their certifications have substantively equivalent requirements for nurses to demonstrate continuing competency. However, the American Association of Critical-Care Nurses – Certification Corporation (AACN-CC) and the National Certification Corporation (NCC) and the American Board for Occupational Health Nurses, Inc. (ABOHN) have certifications approved by NCCA and have specific certifications approved by the BON for nurses. The certifications accepted by the BON for RNs are:
The National Association for Practical Nurse Education & Service, Inc. (NAPNES) offers two certifications for LVNs that have been approved by the Board for demonstration of LVN continuing competency: Pharmacology and Long-Term Care. The two certifications offered by the Developmental Disabilities Nurses Association have also been approved by the Board (one is for RNs and one for LVNs).
PLEASE NOTE: Certification cannot be used to meet the required two contact hours in Nursing Jurisprudence and Nursing Ethics that each nurse must complete prior to the end of each third two-year licensure renewal cycle. A certification meeting BON requirements, related to the older adult or geriatric population may be used to meet the older adult or geriatric care requirement instead of two contact hours.
Requirements for the Advanced Practice Registered Nurse (APRN)
A licensee who is licensed by the Board to practice as an Advanced Practice Registered Nurse (APRN) is required to obtain 20 contact hours of targeted continuing education in the advanced practice role and population focus area recognized by the Board or attain, maintain, or renew the national certification recognized by the Board as meeting the certification requirement for the APRN role and population focus area of licensure; this will satisfy the requirements to renew both the RN license and APRN licensure. The Board approves four broad categories of APRNs including Clinical Nurse Specialist (CNS), Nurse Midwife (CNM), Nurse Anesthetist (CRNA), and Nurse Practitioner (NP).
In addition to the 20 contact hours of continuing education in the advanced practice role and population focus area or renewal of the certification as specified, an APRN who has Prescriptive Authority must also complete at least five additional contact hours in pharmacotherapeutics within the preceding two years. APRNs that have prescriptive authority and prescribe controlled substances must complete at least three additional contact hours of continuing education related to prescribing controlled substances (this totals 28 contact hours for the APRN with prescriptive authority who prescribes controlled substances). Category I Continuing Medical Education (CME) contact hours will meet requirements for continuing competency for APRNs. Academic courses; program development and presentation; and authorship may be utilized to meet continuing competency requirements if they are targeted to the APRN role and population focus area for which they are licensed [Board Rule 216.3(c)].
Academic courses; Program Development and Presentation; and Authorship
Academic courses must be within the framework of a curriculum that leads to an academic degree in nursing or any academic course relevant to nursing practice [Board Rule 216.5(a)]. An academic course taken for credit may be used to meet BON continuing competency requirements if a grade of C or better or “pass” on a pass/fail system is achieved. One academic semester hour is equal to 15 contact hours; one academic quarter hour is equal to 10 contact hours [Board Rule 216.1 (1)]. Prerequisite courses, such as mathematics, government, anatomy, physiology, etc., cannot be counted to meet any part of the continuing competency requirements for a nurse [Board Rule 216.6(10)(A)].
Program Development and Presentation may be used to meet continuing competency requirements for licensure renewal when the program is approved by one of the credentialing agencies approved by the Board [Board Rule 216.5 (b)]. The nurse who developed and/or presented the qualifying program may count the number of contact hours awarded by the credentialing agency or provider to the distinct activity [Board Rule 216.5 (b)(2)].
Authorship of a developed and published manuscript may be used to meet continuing competency requirements for licensure renewal [Board Rule 216.5 (c)]. One contact hour may be counted for each distinct publication [Board Rule 216.5 (c)(2)].
Activities Not Acceptable for CNE Credit
The following activities are not acceptable for CNE credit:
The Board conducts random audits to determine compliance with the continuing competency requirements. Notice is e-mailed to the nurse’s email address on file or mailed to the last known address (if no e-mail is on record). This notice is sent 90 days prior to the renewal dates for nurses who are chosen randomly by computer. The email notification is sent by the BON service provider: e-Strategy Solutions. A nurse being audited will not be able to renew his/her license until adequate proof of continuing competency has been submitted and approved. Please allow up to ten (10) business days for review of the submitted audit. The nurse will receive an email at the address on file, notifying the nurse of the outcome of the audit, and whether any additional action is required by the nurse.
Renewing of License
A nurse renewing the license will be asked if he/she has completed the required 20 hours of CNE within the previous two-year period or has a current national nursing certification and has complied with any targeted CNE requirements. Compliance with continuing competency requirements must be achieved prior to renewal of the nursing license. Continuing competency requirements may be achieved through completion of 20 contact hours or by attaining, maintaining, or renewing an approved national nursing certification in the nurse’s area of practice. Proof of compliance with continuing competency requirements must also be submitted to renew a delinquent license, reactivate a license from inactive status, or when petitioning the Board for reinstatement of a revoked or surrendered license. Each nurse is responsible for maintaining his/her own records of continuing competency compliance. In general, records should be kept for three renewal periods (six years). Evidence of completion of CNE for forensic evidence collection should be maintained indefinitely.
First Time Renewals
A nurse newly licensed in Texas either by examination or by endorsement from another state is exempt from the continuing competency requirement for the first licensure renewal. A nurse’s initial license may be valid for a period ranging from six (6) to 29 months, depending on the licensee’s birth date. Following the first license renewal, the nurse must meet continuing competency requirements for the subsequent biannual renewal periods.
A nurse whose license has expired will be required show proof of completion of 20 hours of CNE, including any targeted CNE requirements, or achievement, maintenance or renewal of an approved national nursing certification within the past two years. This applies whether the license is delinquent for one day or longer.
Requirements for Advanced Practice Registered Nurse (APRN)
A licensee who is authorized by the Board to practice as an Advanced Practice Registered Nurse (APRN) is required to obtain 20 contact hours of targeted continuing nursing education in the advanced practice role and population focus area recognized by the Board or attain, maintain, or renew the national certification recognized by the Board as meeting the certification requirement for the APRN role and population focus area of licensure; this will satisfy the requirements to renew both your RN license and APRN license. The Board approves four broad categories of APRNs including Clinical Nurse Specialist (CNS), Nurse Midwife (CNM), Nurse Anesthetist (CRNA), and Nurse Practitioner (NP). In addition to the 20 contact hours of continuing nursing education in the advanced practice role and population focus area or renewal of the certification as specified, an APRN who has Prescriptive Authority must also complete at least five additional contact hours in pharmacotherapeutics within the preceding two years. Category I Continuing Medical Education (CME) contact hours will meet requirements for continuing competency for APRNs. Academic courses may be utilized to meet continuing competency requirements if they are targeted to the APRN role and population focus area for which they are licensed.
A nurse who is no longer practicing nursing may place the license on inactive status prior to licensure expiration. Continuing education is not required as long as the nursing license is inactive. Should a nurse wish to reactivate the license to return to nursing practice and the nurse has been inactive (or delinquent or retired) for less than four years, the nurse must show proof of completion of 20 hours of CNE, or attainment, maintenance, or renewal of a national nursing certification within the two years prior to the request for reactivation. If the nurse has not practiced nursing in any jurisdiction (i.e. another state) for four or more years, in addition to the CNE hours, the nurse will be required to complete a nursing refresher or extensive orientation course.
A nurse may request “volunteer retired nurse” authorization [Section 301.261 of the Nursing Practice Act (NPA)]. Board Rule 216.3(e) requires a nurse who wishes to provide only voluntary charity care to obtain 10 hours of CNE for each two year authorization renewal cycle. An APRN authorized as a volunteer retired RN in a specific APRN role and population focus area may renew his/her volunteer retired advanced practice license through completion of 20 hours of continuing education targeted to the APRN’s role and population focus area.
Where to Find CNE Offerings
Many CNE offerings may be located on the internet. Local colleges, universities, nursing schools, or large hospitals may have a schedule of offerings or a mailing list. Many nursing journals contain a schedule of offerings. Professional nursing associations are another resource. In addition, the BON has a continuing education course catalog listing those education courses offered by Board staff: https://www.bon.texas.gov/catalog/.
Forensic Evidence Collection CNE
Effective September 1, 2005, the NPA was amended, adding the CNE requirement: Forensic Evidence Collection in Continuing Education. This targeted CNE requirement applies to all nurses practicing in emergency department (ED) settings as either their home unit, floating, contracted, or other duties that involve functioning in an ED setting or role. This is a one-time requirement per nurse effective September 1, 2006. There is no expiration date for this requirement under Texas Occupations Code Section 301.306 (NPA), thus any nurse working in the ED must comply and maintain the course completion certificate indefinitely.
Frequently asked questions on this targeted CNE may be viewed on the BON web page here.
Please retain this informational material for a quick reference on continuing competency (CC). Feel free to copy it and share it with others. The rules specific to CC for nurses are located in 22 Tex. Admin. Code Chapter 216. A copy of the CC rules may be downloaded from the BON web site. Additional copies of this brochure may be obtained by downloading it from the Texas Board of Nursing’s web site located at www.bon.texas.gov. You may also send a stamped, self-addressed envelope to the Board’s office, 333 Guadalupe, Suite 3-460, Austin, Texas 78701, Attn: C.N.E.