Education - Continuing Competency Requirements

Board Rule 216 is the Board’s continuing competency rule and contains complete information on all of the requirements for Texas nurses.

For answers to frequently asked questions about continuing competency, please review the Board’s Continuing Education & Competency FAQs.

• General continuing competency information
• What CNE is acceptable?
• What certifications are acceptable?
• Requirements for LVNs
• Requirements for RNs
• Requirements for APRNs
• Targeted continuing education
• Additional methods of meeting CNE requirements
• List of unacceptable activities
• License renewal
• Maintaining CNE records
• Audit process
• Volunteer Retired Nurse Authorization status
• BON CNE offerings

General Continuing Competency Information

Board Rule 216 is the Board’s continuing competency rule and contains complete information on all of the requirements.  All nurses who wish to maintain an active Texas license are required to demonstrate continuing competency for relicensure. This aligns with the mission of the Texas 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.

For each licensure renewal, Board Rule 216.3 requires every nurse to:

• complete 20 contact hours of continuing nursing education (CNE) in the nurse’s area of practice within the licensing period OR
• demonstrate the achievement, maintenance, or renewal of a Board-approved national nursing certification in the nurse’s area of practice within the licensing period.

Advanced Practice Registered Nurses (APRNs) have additional requirements.  And, there are also targeted continuing education requirements specific to certain nurses.  Each individual nurse is responsible for selecting and participating in appropriate continuing competency activities.

A “contact hour” is a measure of time, determined by Board-recognized credentialing agencies and providers of continuing education, awarded to participants for successful completion of continuing education offerings [Board Rule 216.1(10)].

The Board defines “area of practice” as any activity, assignment, or task in which the nurse utilized nursing knowledge, judgment, or skills during the licensing period.  If a nurse does not have a current area of practice, the nurse may refer to his or her most recent area of practice [Board Rule 216.1(4)].

The Board’s definition of a “licensing period” is the period of time in which nursing licensure status is current, determined by the licensee's birth month and year (usually beginning on the first day of the month after the birth month and ending on the last day of the birth month). The specific time frame for initial licensure and for the immediate licensing period following renewal of a delinquent license or license reactivation may vary from 6 to 29 months, as determined by Board policies; but, subsequent licensing periods will be 2 years in length [Board Rule 216.1(14)].

Examples:

• John, RN, was born in November 1957
• Based on his birth month and year, John’s license will always expire on November 30th of odd-numbered years. 
• Examples of his standard, 2-year licensing periods are:
• December 1, 2017 to November 30, 2019
• December 1, 2019 to November 30, 2021
• Etc.
• So, when John renews his RN license in November 2019, for instance, he will need to have completed the continuing competency requirements sometime between December 1, 2017 and the day that he applies to renew in November 2019.
• Mary, LVN, was born in June 1992
• Based on her birth month and year, Mary’s license will always expire on June 30th of even-numbered years. 
• Examples of her standard, 2-year licensing periods are:
• July 1, 2018 to June 30, 2020
• July 1, 2020 to June 30, 2022
• Etc.
• So, when Mary renews her LVN license in June 2020, for instance, she will need to have completed the continuing competency requirements sometime between July 1, 2018 and the day that she applies to renew in June 2020.

It’s important to always be aware of when your license expires and renew your license before the expiration date.  If you do not renew your license before the expiration date, your license will go into delinquent status, and you cannot practice/work as a nurse with a delinquent license.  You will not be able to practice nursing until your license is successfully renewed and placed into an active/current status. 

Requirements for LVNs and RNs
Requirements for APRNs

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What CNE is Acceptable?

A nurse may choose to demonstrate compliance with the continuing competency requirements by completing 20 contact hours of Continuing Nursing Education (CNE) in his or her area of practice within the licensing period [Board Rule 216.3(a)]. 

Local colleges, universities, nursing schools, or large hospitals may have a schedule of CNE offerings or a mailing list.  Many nursing journals and professional nursing associations also contain a list of offerings.  And, many CNE offerings may be located on the internet.  Any course/ offering/ activity/ program that offers Continuing Nursing Education (CNE) contact hours and is in the nurse’s area of practice can be used for licensure renewal so long as it is approved by a credentialing agency or provider recognized by the Board. 

Board-recognized credentialing agencies and providers have met nationally predetermined criteria to approve programs and providers of CNE and include:

• American Association of Critical-Care Nurses (AACN),
• American Association of Nurse Anesthetists (AANA),
• American Association of Nurse Practitioners (AANP),
• American College of Nurse-Midwives (ACNM),
• American Nurses Credentialing Center (ANCC),
• Colleges and Universities in the United States of America,
• Emergency Nurses Association (ENA),
• Licensed Vocational Nurses Association of Texas (LVNAT),
• National Association for Practical Nurse Education and Service, Inc. (NAPNES),
• National Association of Licensed Practical Nurses (NALPN),
• National Association of Pediatric Nurse Practitioners (NAPNAP),
• National League for Nursing (NLN),
• Other State Boards of Nursing, and
• Texas League of Vocational Nurses (TLVN).

Please note: Some of the above listed Board-recognized credentialing agencies and providers have authority to approve other CNE providers.  For example, some state nursing associations and many nursing specialty organizations are accredited through the ANCC to provide CNE and/or approve programs or other providers of CNE programs. Thus, these programs would also be acceptable to the Board, if in the nurse’s area of practice, because the umbrella organization that accredited the program or provider is ANCC, which is a Texas BON-recognized credentialing agency and provider.

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What Certifications are Acceptable?

A nurse may choose to demonstrate compliance with the continuing competency requirements by achieving, maintaining, or renewing a Board-approved national nursing certification in the nurse’s area of practice within the licensing period in lieu of completing 20 contact hours of Continuing Nursing Education (CNE) in his or her area of practice [Board Rule 216.3(b)]. 

Board-approved national nursing certifications have been determined to be substantively equivalent to the traditional CNE contact hours required by the BON for licensure renewal and include:

¹The Accreditation Board for Specialty Nursing Certification (ABSNC) accredits several certification programs offered by a variety of certifying organizations.  Any national nursing certification accredited by the ABSNC that is achieved, maintained, or renewed within the licensing period and is in the nurse’s area of practice is acceptable to demonstrate the nurse’s continued competence for licensure renewal. 

²The National Commission for Certifying Agencies (NCCA) also accredits many certification programs offered by a variety of certifying organizations.  Not all of the certifications accredited by the NCCA substantively meet the continuing competency requirements of the Board; the certifications listed in the table above are the only NCCA accredited certifications that are approved by the Board to demonstrate the nurse’s continued competence for licensure renewal. 

Please note: Certification may not be used to fulfill the Nursing Jurisprudence and Nursing Ethics CNE requirement.  All nurses (LVNs, RNs, and APRNs) must complete traditional CNE contact hours to fulfill the Nursing Jurisprudence and Nursing Ethics CNE requirement [Board Rule 216.3(g)].

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Requirements for LVNs and RNs

For licensure renewal, LVNs and RNs must complete 20 contact hours of continuing nursing education (CNE) in the nurse’s area of practice OR demonstrate the achievement, maintenance, or renewal of a Board-approved national nursing certification in the nurse’s area of practice within the licensing period and meet the applicable targeted continuing education requirements. [Board Rule 216.3]

Board Rule 216.1(4) defines “area of practice” as “any activity, assignment, or task in which the nurse utilized nursing knowledge, judgment, or skills during the licensing period. If a nurse does not have a current area of practice, the nurse may refer to his or her most recent area of practice.”

Continuing competency requirements must be earned within the two-year period immediately preceding license renewal, beginning on the first day of the month after the renewal month through the last day of the subsequent renewal. For example, if a nurse is required to renew the nursing license in December 2019 (his/her birth month), then the continuing competency requirements must be earned between January 1, 2018 and December 31, 2019 (the licensing period for the December 2019 renewal).  Additional hours earned may not be carried over to the next renewal period.

If a nurse chooses to complete CNE to meet the Board’s continuing competency requirements, the CNE activity/program must be in the nurse’s area of practice and approved by a credentialing agency or provider recognized by the Board.  Click here to see a list of Board-recognized credentialing agencies and providers of CNE.  [Board Rule 216.3(a)]

If a nurse chooses to achieve, maintain, or renewal a national nursing certification to meet the Board’s continuing competency requirements in lieu of completing 20 contact hours of CNE, the certification must be in the nurse’s area of practice and approved by the Board.  Click here to see a list of Board-approved certifications.  [Board Rule 216.3(b)]

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Targeted Continuing Education

Board Rule 216.1(21) defines “targeted continuing education” as continuing education offerings beyond the basic scholastic preparation which are designed to promote and enrich knowledge, improve skills, and develop attitudes for the enhancement of nursing practice that are directed by statute and Board rules at specific levels of licensure and/or areas of practice.  Please review the following table, categorized by CNE topic, to determine what targeted continuing education applies to you based on your level of licensure and/or area of practice.  However, do note that all nurses must comply with the Nursing Jurisprudence and Nursing Ethics requirement discussed in Board Rule 216.3(g). 

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Requirements for APRNs

Like all nurses in Texas, APRNs are required to complete 20 contact hours of continuing education appropriate to the advanced practice role and population focus area recognized by the Board OR achieve, maintain, or renew the national nursing certification recognized by the Board as meeting the certification requirement for the APRN's role and population focus area of licensure within the licensing period and meet the applicable targeted continuing education requirements. This will satisfy the requirements to renew both the RN license and APRN license. In other words, the required 20 contact hours for APRNs are not in addition to the required 20 contact hours for RN license renewal. [Board Rule 216.3]

Any APRN who holds prescriptive authority must complete, in addition to the aforementioned 20 contact hours required for all APRNs, at least 5 additional contact hours of continuing education in pharmacotherapeutics. These hours are above and beyond the 20 hours required for all nurses. Also, some APRNs may have additional requirements related to prescribing (e.g., prescription of opioids, Texas Prescription Monitoring Program) which do count towards completion of the 20 hours required for all nurses. Please review the targeted continuing education requirements to determine what additional CE hours you may need.

Continuing competency requirements must be earned within the two-year period immediately preceding license renewal, beginning on the first day of the month after the renewal month through the last day of the subsequent renewal. For example, if a nurse is required to renew the nursing license in December 2019 (his/her birth month), then the continuing competency requirements must be earned between January 1, 2018 and December 31, 2019 (the licensing period for the December 2019 renewal). Additional hours earned may not be carried over to the next renewal period.

APRNs can use Category I Continuing Medical Education (CME) contact hours to meet their BON continuing competency requirements for all requirements except the Nursing Jurisprudence and Nursing Ethics CNE requirement.

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Additional Methods for Meeting Continuing Competency Requirements (other than traditional CNE or certification)

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Activities Not Acceptable as Continuing Education

According to Board Rule 216.6, the following activities do not meet continuing education requirements for licensure renewal:

• Basic Life Support (BLS);
• Cardiopulmonary resuscitation (CPR);
• In service programs sponsored by the employing agency to provide specific information about the work setting and orientation or other programs which address the institution's philosophy, policies and procedures, on-the-job training, and equipment demonstration;
• Nursing refresher courses designed to update knowledge of current nursing theory and clinical practice, which consist of a didactic and clinical component, to ensure entry level competencies into nursing practice;
• Orientation programs designed to introduce employees to the philosophy, goals, policies, procedures, role expectations, and physical facilities of a specific work place;
• Courses which focus upon self-improvement, changes in attitude, self-therapy, and self-awareness that do not delineate the impact on nursing practice or improved patient outcomes;
• Economic courses for financial gain (e.g., investments, retirement, preparing resumes, and techniques for job interview);
• Courses which focus on personal appearance in nursing;
• Liberal art courses in music, art, philosophy, and others when unrelated to patient/client care;
• Courses designed for lay people;
• Self-directed study/educational activities wherein the learner takes the initiative and the responsibility for assessing, planning, implementing, and evaluating the activity including, but not limited to, academic courses that are audited, that are not directly relevant to a licensee's area of nursing practice, or that are prerequisite courses such as mathematics, physiology, biology, government, or other similar courses; and
• Continuing Medical Education (CME), unless completed by an APRN in the APRN's role and population focus area of licensure (with the exception of the Nursing Jurisprudence and Nursing Ethics CNE requirement—APRNs must complete CNE, not CME, to fulfill that requirement).

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License Renewal

Board Rule 216.8 describes the relicensure process.  In Texas, nursing licenses are typically valid for a 2-year period, meaning nurses typically need to renew their licenses every 2 years.  However, there are some instances when the licensing period may not be the standard, 2-year period:

• a nurse’s initial license is valid for a period of 6 to 29 months, depending on his/her birth month and year and when the initial license is issued and 
• the first licensing period after renewal of a delinquent license or reactivation of an inactive license may also be 6 to 29 months. 

*After the first renewal and after delinquent renewal or reactivation, the nurse’s licensing period will be the standard, 2-year licensing period, and the license will need to be renewed every 2 years.  Nurses need to remember that in all cases, the license will ALWAYS expire on the last day of the nurse’s birth month, in odd-numbered years if the nurse was born in an odd-numbered year and in even-numbered years if the nurse was born in an even-numbered year.   

When you renew your license, you are required to sign a statement attesting that the continuing competency requirements have been met (CNE contact hours or approved national nursing certification, and any applicable targeted continuing education requirements).  The contact hours you use to renew must have been completed within the licensing period and by the time of application for license renewal.  Renewing your license without completing the continuing competency requirements is grounds for disciplinary action by the Board.  In other words, do not apply to renew your license until you have completed all of your requirements. For example, if your RN license expires in August, but you only have 18 contact hours of CNE by mid-August and plan to attend a course on August 28th awarding the remaining two contact hours you need, you have to wait until after you have completed the course on August 28th before you can renew because you will not have the required 20 contact hours of CNE until then.  But, be sure to renew by August 31st (last day of birth month) to avoid having your license expire and go into delinquent status. Any contact hours earned in a previous licensing period will not be accepted, and additional contact hours earned may not be used for subsequent licensure renewals.

First Renewal (Initial Renewal)
A nurse’s initial license is valid for a period of 6 to 29 months, depending on his/her birth month and year and when the initial license is issued.  Nurses are exempt from most continuing competency requirements for the first renewal following initial licensure as long as the initial renewal is timely.  The only exception is the Forensic Evidence Collection [Board Rule 216.3(d)] targeted continuing education requirement, if it applies based on the nurse’s practice.  After the initial licensing period, subsequent licensing periods will be 2 years in length.  And, following the initial renewal/very first renewal, nurses need 20 contact hours of Continuing Nursing Education (CNE) in their area of practice or a Board-approved national nursing certification in their area of practice to renew their license each 2-year licensing period.

Delinquent Renewal
If you do not renew your license before it expires, it will go into delinquent status.  A nurse whose license has expired will be required to show proof of continuing competency. 

If your license has been delinquent for less than four years, you may renew by submitting proof of having completed 20 contact hours of acceptable CNE or a current approved national nursing certification in your prior area of practice within the two years immediately preceding application for relicensure and by meeting all other Board requirements.  You will be exempt from the continuing competency requirements for the immediate licensing period following renewal of the delinquent license with the exception of the Forensic Evidence Collection [Board Rule 216.3(d)] targeted continuing education requirement, if it applies based on the nurse’s practice. 

If your license has been delinquent for four or more years, you may renew according to Board Rule 217.6.

License Reactivation
If your license has been inactive for less than four years, you may reactivate the license by submitting proof of having completed 20 contact hours of acceptable CNE or a current approved national nursing certification in your prior area of practice within the two years immediately preceding application for reactivation and by meeting all other Board requirements.  You will be exempt from the continuing competency requirements for the immediate licensing period following reactivation of the license with the exception of the Forensic Evidence Collection [Board Rule 216.3(d)] targeted continuing education requirement, if it applies based on the nurse’s practice. 

If your license has been inactive for four or more years, you may reactivate the license according to Board Rule 217.9.

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Maintaining Record of Continuing Competency

All nurses are responsible for selecting and participating in continuing competency activities that will meet the requirements and criteria listed in Chapter 216 of the Board’s rules.  Each individual nurse must maintain continuing competency records that document attendance as evidenced by original certificates of completion, contact hour certificates, or official academic transcripts.  Nurses must keep these records for a minimum of three consecutive licensing periods or six years (with the exception of the Forensic Evidence Collection targeted CNE requirement, which must be kept indefinitely) [Board Rules 216.7 & 216.3(d)(3)].

Proof of successful completion of continuing education must contain:

• name of the provider;
• program title, date, and location;
• number of contact hours;
• provider number; and
• name of the credentialing agency.

This information is usually documented on a CNE Certificate of Completion.  Certification cards are not acceptable, for example from ACLS or PALS courses, etc.  Proof of successful completion must contain the information specified above, as seen in Board Rule 216.4.

You do not need to submit copies of documents validating continuing competency compliance unless you are notified that you are subject to an audit [Board Rule 216.9].

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Audit Process

Nurses do not need to submit proof of compliance with the continuing competency requirements unless audited.  So, if not subject to an audit, you do not need to send any documentation to the Board to substantiate your compliance.  Board Rule 216.9 describes the audit process. 

The Board conducts audits to determine compliance with the continuing competency requirements by selecting a random sample of nurses 90 days prior to each renewal month. The Board sends written notification to selected nurses via postal mail.  (If a nurse has an email address on file with the Board, he/she will also receive email notification by eStrategy Solutions, Inc. (eSS), a contract service provider to the Board.) 

The audit process is completed online via a portal managed by eSS.  An email address is required for access to the portal.  Nurses will receive an email at the email address on file with the Board with notice of the outcome of the audit or whether any additional action is required by the nurse.  If you’ve been selected for an audit, you will not be able to renew your license until adequate proof of compliance with the Board’s continuing competency requirements has been submitted, reviewed, and approved.  Please allow up to 10 business days for processing.   Nurses who are being audited may locate information and instructions at https://ce.esslearning.com.

Nurses must keep their legal name and mailing address information current with the Board.  Nurses are required to notify the Board in writing within 10 days of a change of address, providing the Board with the new address information [Board Rule 217.7(b)].  Failure to notify the Board of an address change will not absolve the licensee from audit requirements.

Any nurse who is noncompliant with an audit will automatically be audited again in the next licensing period.  It is considered unprofessional conduct and grounds for disciplinary action by the Board if a nurse fails to satisfactorily complete the audit or falsifies records as part of the audit.

Board Rules 216.4, 216.5, and 216.7(b) describe proof of compliance documentation and records. 

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Volunteer Retired (VR) Nurse Authorization Requirements

Please read Board Rule 217.9(e) for information about VR Nurse Authorization, including scope and limitations of practice.  To follow are the continuing competency requirements for nurses with VR Nurse Authorization. 

LVNs & RNs:
Complete at least 10 contact hours of CNE in the area of practice within the two years immediately preceding application for, or renewal of, VR status.  Volunteer Retired nurses are exempt from fulfilling targeted continuing education requirements.

APRNs:
Complete at least 20 contact hours of continuing education in the area of practice within the two years immediately preceding application for, or renewal of, VR status. The 20 hours of continuing education must meet the same criteria as APRN continuing education defined under Board Rule 216.3(c). A nurse authorized as a VR-RN/APRN may not hold prescriptive authority. However, a nurse may place his or her APRN license on inactive status and apply for authorization only as a VR-RN.  Volunteer Retired nurses are exempt from fulfilling targeted continuing education requirements.

Please note: A nurse whose license is in "retired" status has an invalid license, may not practice as a nurse, and therefore has no continuing competency requirements.  A “retired” license is different from a “VR Nurse Authorization”.   Please read Board Rule 217.9 for more information about the distinctions. 

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BON CNE Offerings

For information regarding continuing education offerings hosted by the Texas Board of Nursing, please visit the CNE Course Catalog.

Courses Approved to Meet BON Stipulations for nurses with disciplinary action may also be found on the BON website.  Please note that CNE contact hours cannot be earned for courses taken to fulfill stipulated requirements of BON disciplinary orders. 

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(Revised 02/2019)