This section provides Frequently Asked Questions (FAQ) pertaining to practice (topics are in alphabetical order). These materials are for informational purposes only and not for the purpose of providing legal advice. You should contact your attorney to obtain advice with respect to any particular issue or problem.
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More Anesthesiologist Assistants (AA) Questions
APRNs in Texas may either complete 20 hours of CE or maintain national nursing certification and meet the applicable targeted CE requirements. While the continuing education requirements for NBCRNA certification exceed the 20 CEs required for APRN licensure in Texas, they do not meet the targeted CE…
Board Rule 221.4 requires national certification for all applicants who have completed their education. Currently, the only national certification exam that is recognized by the Board for CRNAs is the NBCRNA. While some states still allow APRNs to practice prior to passing the exam, Texas does not.…
More Continuing Education (CE) Questions
More Cosmetic Procedures Questions
A dentist may only delegate the ordering of anesthesia if the dentist possesses the appropriate level of anesthesia permit for the type of anesthesia service being ordered. If the dentist does not possess the appropriate level of permit, the order for anesthesia would need to come from a physician…
Termination provisions are one of the most overlooked but troublesome components of a contract. The reason these covenants are so troublesome is not only that a CRNA’s old employer may seek to enforce the non-compete; other companies may avoid hiring the CRNA out of concern for being sued.…
A CRNA finding themselves in a position of being asked to sign any contract should seek competent advice from an attorney familiar with the laws that apply to the employment or independent contractor relationship. In addition to consulting an attorney, CRNAs should familiarize themselves with…
More Employment Contracts Questions
As with any other treatment, the role and scope of practice of a CRNA depends largely on their competencies. Every CRNA also has a duty to provide safe care to their patients. Under certain circumstances, and pursuant to a delegating provider's order, ketamine infusion therapy can be…
There are currently no additional requirements for mobile anesthesia providers. However, depending on the practice locations and the type of authority you would prefer, your registration requirements could vary. For example, if you need to write prescriptions, you will need to obtain a Prescriptive…
More Mobile Anesthesia Questions
The outpatient anesthesia application is a separate application from the licensure renewal application, but it is also done through the Texas Nurse Portal. After logging in to their Nurse Portal account, scroll down to the box labeled "Other Applications." On the right side of the Other Applications…
In outpatient anesthesia settings, the drugs administered and devices applied by a CRNA who provides anesthesia or anesthesia-related services are supplied by the practice setting. Therefore, they are ordered for use in that setting by the surgeon. Just as in the hospital or ambulatory surgery…
More Office-Based Setting Questions
APRNs with prescriptive authority are required to check a patient’s PMP history before dispensing or prescribing opioids, benzodiazepines, barbiturates, or carisoprodol. In other words, CRNAs who prescribe pursuant to a Prescriptive Authority Agreement are required to check the PMP prior…
There is no requirement in Texas state law or by the BON for a physician co-signature on orders written by a CRNA in the perioperative period. Board Rule 221.15(a) establishes the legal basis for the ordering of drugs and devices by a CRNA in a licensed hospital or ambulatory surgical…
More Orders/Prescriptive Authority Questions
As a landmark 2011 study by the Institute of Medicine (IOM) reported, pain is a serious public health problem, with at least 100 million U.S. adults suffering from chronic pain, at an annual economic cost of up to $635 billion.1 To help address this problem, Certified Registered Nurse Anesthetists…
More Pain Management Questions
Nursing Peer Review is the preferred method for a review of practice for all levels of nursing licensure. The Chief Nursing Officer (CNO) is responsible for establishing the policies and procedures necessary for peer review of all nursing practice, including APRNs. When peer review…
If a CRNA provides anesthesia services upon request from a podiatrist, it is important to understand that podiatrists in Texas are not licensed to provide general anesthesia. Although podiatrists have prescriptive authority, they do not have the authority to delegate the ordering of…
There are no CRNA specific regulatory statutes that apply to CRNAs in Texas performing radiologic procedures. The Texas Board of Nursing Rule 217.14 applies to CRNAs performing radiologic procedures in Texas. Board Rule 217.14(a) requires registration with the Board of Nursing for…
More Radiation/Fluoroscopy Questions
The APRN's scope of practice is addressed in Board Rule 221.12. The rule states the APRN’s scope of practice is based upon educational preparation, continued advanced practice experience, and the accepted scope of professional practice of the particular specialty area. …
More Scope of Practice Questions
The CRNA in the room should only be engaged in the anesthesia related care of the patient to whom they are providing anesthesia services. The AANA position statement entitled The Role of the CRNA on the Procedure Team explains: Patient safety may be compromised when the CRNA is asked to serve…
More Standard of Care Questions
A Texas CRNA may practice independent of an anesthesiologist. There are no Texas state laws or regulations requiring physician supervision of CRNA practice, including CRNA practice in an office based setting. A CRNA may not order the drugs and devices necessary for the administration of an…
Texas Board of Nursing Office Based Anesthesia FAQ related to passage of SB 406: Is a nurse anesthetist required to have prescriptive authority and register that delegation with the Texas Medical Board? In outpatient anesthesia settings, the drugs administered and devices applied by a CRNA…
More Surgeon Liability Questions
CRNAs in Texas are authorized to perform regional anesthesia, including ultrasound guided regional anesthesia (USGRA). Regional anesthesia is an integral part of anesthesia practice. The American Association of Nurse Anesthetists determines Scope of Nurse Anesthesia…
More Ultrasound-Guided Procedures Questions
For questions about matters dealing with federal law or regulations, the American Association of Nurse Anesthetists (AANA) is the best point of contact. Contact information is available here: Contact Us Portal.
The Texas Board of Nursing (BON) is the best contact for questions that relate specifically to specific inquiry facts and circumstances. As TxANA is unable to provide legal advice, we can tell you the law, but not how it applies to specific circumstances. The BON is able to address these types of…
