Revised 10/2016
Vocational Nursing (VN/PN) Refresher Course/Extensive Orientation/Academic Nursing Course(s)
Overview of Requirements
General Requirements: Each content area indicated below will have: course description, goals and objectives, resources
to be utilized, break-down of didactic and clinical content, and methods to be used to determine successful completion of
the course. Total didactic and clinical hours should be based on individual need and comprehensive assessment of the
competency level of the nurse. The Differentiated Competencies of Graduates of Texas Nursing Programs,
http://www.bon.state.tx.us/about/pdfs/del-comp.pdf, should serve as the guideline for the evaluation of competency. Didactic
review must be completed by an RN Instructor. Clinical review can be performed by an LVN or RN preceptor in
collaboration with the RN Instructor and must be a minimum of 80 hours in direct patient-care hours. Home study and/or
video-based programs are not acceptable as the primary or sole means of instruction.
1) Review of NPA, Rules, Position Statements
Must include Standards of Nursing Practice, Misconduct Rules, Eligibility Requirements relating to good professional
character and ethical conduct, including professional boundaries, Peer Review (incident-based and safe harbor), CE
requirements, and licensure renewal requirements. It is recommended that this content constitutes 15% of Refresher
Course/Extensive Orientation/Academic Nursing Course(s) time.
2) Determining Individual Scope of Practice
Must include a review of all the scope of practice documents on the Board’s website, listed under “Nursing Practice”,
then under “Scope of Practice”, including identification of Standards of Nursing Practice, Decision-Making Model for
Determining Nursing Scope of Practice, evidenced-based best practices for practice setting focus, and other current
reference material relevant to patient safety and the nurse’s practice. It is recommended that this content constitutes
5% of Refresher Course/Extensive Orientation/Academic Nursing Course(s) time.
3) Review of the clinical problem solving process (systematic approach) for the provision of individualized, goal
directed nursing care
Must include both didactic and clinical practice related to data collection (including physical assessment to cover all
body systems), planning, implementation and evaluation. The content must reflect the Standards Specific to LVNs
identified in Rule 217.11(2). It is recommended that this content constitutes 30% of Refresher Course/Extensive
Orientation/Academic Nursing Course(s) time.
4) Pharmacology Review
Must include a didactic component; content must cover all major drug classifications and their physiological and
therapeutic effects, dosages, administration, precautions, contraindications, side effects/adverse reactions and nursing
implications. Courses focusing exclusively on drugs for specific disease processes shall not count. In addition, specific
courses focusing on emergency management of certain conditions, such as Advanced Cardiac Life Support shall not
count. It is recommended that this content constitutes 20% of Refresher Course/Extensive Orientation/Academic
Nursing Course(s) time.
5) Medication Administration
Must include both a didactic (excluding home study) and clinical application components. Content must include review
of proper administration procedures for all standard routes, computation of drug dosages, 5 rights of medication
administration, factors influencing the choice of route, and possible adverse effects resulting from improper
administration. If proficiency in administration of drugs by intravenous routes is to be covered, this content must be
in addition to the above required didactic and clinical minimum hours, and shall be in alignment with currently accepted
course content and clinical practice hours established by national specialty nursing organizations and/or vocational
nursing education programs. Must also include current information on national patient safety initiatives and
recommendations for safe medication administration practices. It is recommended that this content constitutes 20%
of Refresher Course/Extensive Orientation/Academic Nursing Course(s) time.
6) Documentation, quality assurance and legal implications for nursing practice.
Must include a didactic component. Content must include nursing standards related to accurate and complete
documentation, legal guidelines for recording information into records pertaining to clients, methods and processes
of recording, methods of alternative record keeping, including computerized documentation, acceptable methods of
making late entries, and documentation practices considered to be unethical/illegal. Discussion should include basic
principles and concepts of quality assurance. Evaluation of the ability to document care effectively must be included
in clinical portion of refresher. It is recommended that this content constitutes 10% of Refresher Course/Extensive
Orientation/Academic Nursing Course(s) time.