Analysis of the Texas Nurse Practice Act

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In the nursing field it is very important to understand what is needed when giving a patient medication. If we are not careful, we could over or under medicate a patient and this would create problems for them and for nurses. There are several ways to make sure that we give proper medication. Two of these ways are governed by specific nursing legislation and the third is from federal legislation.

Medication errors have been a problem in medicine and there is legislation that regulates the way that medication should be handled. According to The Texas State Board of Pharmacy, “medication errors occur when a drug has been inappropriately prescribed, dispensed, or administered.” (n.d., par. 1). This situation can happen in any healthcare situation at any time. The article goes on to say that in the past, it was thought that medication errors were due to challenges with individuals, but reports have found that it is an overall management challenge in healthcare.

The statement that they created along with the Texas Board of Nurse Examiners says that nurses basically should keep up with the new medications and with new procedures through professional development. They should also make sure that they only take assignments for which they qualify and must ask for help when they need it.

According to the Texas Nurse Practice Act, medication is only to be given to a patient when a physician, podiatrist or dentist prescribes this medication (TNPA, 2005, p. 10). This can help nurses understand when the appropriate medicine is supposed to be given.

The Joint Commission is the group that has as its goal to make sure that certain standards are met by healthcare professionals who are members of their organization. Most healthcare programs to insure the quality of these programs. According to their mission they work to “continuously improve the safety and quality of care provided to the public through the provision of health care accreditation and related services that support performance improvement in health care organizations”.  (Joint Commission, 2008, “About Us”). Their website gives a wealth of information to healthcare programs and to consumers. If a healthcare practitioner has a question of any kind, the Joint Commission probably has the answer in their question and answer section. One of the features that they have that concerns medication is a brochure to give to consumers. In it, they tell how to be more responsible for your own medication and how to make sure that you get what you need. They also include the standards for medication and how to make sure that the patient is taken care of properly.

The Joint Commission only works with accrediting programs but they do not set legislation. They depend on other groups like the Nursing Practice Act and the Texas Board of Nursing to develop the legislation. However, they do have a section of standards that are important to know. Their emphasis is on a “well planned and implemented medication system [to] support client safety and improve the quality of care” (JC, 2008, “Medication”, p. 1) by doing several things. They spell out in detail in their medication management section everything that someone needs to for medication. They also include herbal remedies, vitamins, nutarceuticals and over the counter drugs.

Federal legislation governs what the other state and local communities can do. There are several laws that help medication standards. The Pure Food and Drug Act of 1906 established the USP and NF as the ‘official” references that establish drug standards. The Federal Food, Drug and Cosmetic Act of 1938 gave power to the Federal Drug Administration (FDA) so they could test any new drugs before they were given to the general public; this was amended in 1952 to put prescription drugs and over-the-counter drugs into different categories. The Harrison Narcotic Act of 1914 classified certain habit forming drugs as started regulating them (DeLaune and Ladner, 2002, p. 674).

The states then define the functions of nurses and their responsibilities which again go back to the State Nurse Practice Act in each state. Healthcare institutions can become more restrictive in some areas but they cannot change the federal laws; state and local regulations have to conform to the federal regulations (DeLaune and Ladner, p. 675).

The Texas Board of Nursing is the other governing arm for nurses in Texas. Their mission is “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”. (Texas Board of Nursing, homepage). This site makes sure that nurses have all the information they need to apply for licensing and makes sure that healthcare programs are also licensed. An individual could technically go online to this website to make sure that a nurse is licensed and has the proper credentials to practice in Texas.

All of the sites have a lot of information on them and anyone who is practicing nursing can learn a lot just by going to any of the sites. All classes have to meet the standards that are set out for licensing as well.

One of the areas that are important to the Texas Board of Nursing is the area that describes Scope of Practice. In the Frequently Asked Questions (FAQ) section, they list the tasks that a nurse can and cannot perform. They make it clear that nurses cannot give medical diagnosis and they cannot prescribe medication. (Texas Board of Nursing, FAQ, par. 3).

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  1. DeLaune, S. and Ladner, P. (2002).Fundamentals of nursing standards of practice. 2nd Edition. NY: Thomas Delmar Learning,
  2. The Joint Commission. (2008). About us. Retrieved June 17, 2008 from
  3. The Joint Commission. (2008). Medication Management. Retrieved June 17, 2008 from
  4. Texas Board of Nursing (n.d.).  FAQ – List of Tasks a Nurse Can/Cannot Perform. Retrieved June 16, 2008 from
  5. The State of Texas. (2005). Texas State nurse practice act, nursing peer review and nurse licensure compact. Texas occupations code and statutes regulating the practice of nursing. As amended September 2005. Retrieved June 16, 2008 from
  6. Texas State Board of Pharmacy. (n.d.). Texas board of nurse examiners/board of pharmacy joint position statement on medication errors. Retrieved June 16, 2008 from management.
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