Q: Dear Nancy,
I work for a therpeutic group home where all employees are required under the state law to have annual PPD tests for tuberculosis screening. The RN of the group home administers the PPD tests and reads them for the employees. However, there is no doctor’s order for the test and no physician or house officer. The nurse has been trained and certified by the health department in administering and reading PPDs. Is it legal for the nurse to test employees without a doctor’s order?
It is assumed that if the nurse giving the PPD test and reading it where you work is certified by the state department of health that there is either a waiver of the need for a specific order or prescription. Another possibility is there are standing orders somewhere (e.g., discussed in the state’s law or the rules of its department) to do so.
You can check for this information online by placing “state department of health” in your search bar and when the home page appears, look for PPD test administration, requirements for PPD test certification or something similar. You can also review the state department of health’s authority and powers by reviewing the actual statute by searching under “state department of health statute” or “rules and regulations of the department.” There is often a wealth of information on state websites, and taking a little time to research your question may resolve any concerns you have.
Calling your local health department and speaking to someone there also may be an option.
You also can seek the answer to your question through a consultation with a nurse attorney or other attorney in your state. The state board of nursing and/or the nurse practice act itself may help shine additional light on your question.
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