The Texas BON requires all APRNs graduating from an advanced nursing program after January 1, 1996, to be certified by a national certifying body recognized by the BON in an appropriate advanced practice role and specialty, unless specially waived by the Board and substituted for 1,000 hours of supervised practice upon hire required. The CNS provides expert comprehensive nursing care directly to patients, supports and develops registered nurses at the point of care and serves as a leader in redesigning systems to improve access, quality, and safety in a cost-effective manner.