TB Testing/Reading Question

[hayest]

Can a medical assistant read the results of a TB skin test and sign off on it?

The majority of the states don't have anything formally written on what medical assistants can do and some states do, but there are many articles indicating general regulations or the scope of practice.

I understand they can administer the test and pass on their observations of the results to the MD, but the MD needs to read the test.

The State Board of Healing Arts indicates an unlicensed person cannot interrupt tests, which includes skin tests.

When graduating from a medical assistant training program, if a medical assistant does not become certified or even if they do, are they still considered nationally certified? Or nationally certified to read TB tests?

Thank you

[Rose_Queen, BSN, MSN, RN]

but the MD needs to read the test.

Not necessarily. It really depends on scope of practice and facility policy. My facility used to require annual PPD testing; it now only requires testing for those who are considered to work in high risk departments and those who are exposed to a patient later diagnosed with TB. The test is administered by occupational health and read by an occupation health RN. It is not required that an MD read the result.

A lot of your posts indicate that you are a healthcare consumer rather than a healthcare worker. If you have concerns, they need to be addressed by the provider, not an anonymous message board.

[hayest]

Not necessarily. It really depends on scope of practice and facility policy. My facility used to require annual PPD testing; it now only requires testing for those who are considered to work in high risk departments and those who are exposed to a patient later diagnosed with TB. The test is administered by occupational health and read by an occupation health RN. It is not required that an MD read the result.

Thank you for your reply. Several people were having a discussion about this and I thought I would ask it on this website ... I understand an RN can read a TB test, but I was curious if a medical assistant can read/interrupt when there is no RN in the office. I appreciate your speedy reply. I hope you have a wonderful day.

[bugya90, ASN, BSN, LVN, RN]

Medical assistants are not licensed and are typically working under a facility policy. In our facility and many others in the area medical assistants cannot administer or read a PPD test. Only licensed people can (LVN, RN, PA, NP, MD). The providers in our facility won't place them because as they say they haven't done it since school and are out of practice on intradermal placement. They will however read them if myself and the other nurses are busy or are questionable on a result.

[hayest]

Medical assistants are not licensed and are typically working under a facility policy. In our facility and many others in the area medical assistants cannot administer or read a PPD test. Only licensed people can (LVN, RN, PA, NP, MD). The providers in our facility won't place them because as they say they haven't done it since school and are out of practice on intradermal placement. They will however read them if myself and the other nurses are busy or are questionable on a result.

Thank you for taking the time to reply to my question. I appreciate your answer. What would "they are certified and trained - "nationally trained" to read them mean? We'v heard a few MD's and office managers make that statement. If a medical assistant is nationaly trained -- does that mean they can read/interpret the TB test site? Thank you

[WCSU1987]

I had to have some weird TB test done you needed two or one and a recent one from a year. Anyways nurse, pa, or doc could read it in my state of CT.

[JustBeachyNurse, LPN]

There is training to a national standard and certified by a national agency but no such thing as "nationally trained". In my area they may place the test but reading requires interpretation and it is out of their scope. Reading must be by a licensed nurse, APN, PA or physician in my area. There have been a few large incidents with "certified" MA's misreading hives/local allergic reaction as a positive PPD. MA cannot legally sign the interpretation only a nurse, PA, APN or physician can sign. Therefore most practices now refer to the nurses at the health department as the test can be done for $5 or less if there was a verified exposure. $5 is screening fee such as for employment or to join an ambulance corps. The nurses work under the County ID MD protocol & CDC guidelines for interpretation and subsequent referral for additional testing (repeat test, chest X-ray, refer to MD for treatment)

[hayest]

There is training to a national standard and certified by a national agency but no such thing as "nationally trained". In my area they may place the test but reading requires interpretation and it is out of their scope. Reading must be by a licensed nurse, APN, PA or physician in my area. There have been a few large incidents with "certified" MA's misreading hives/local allergic reaction as a positive PPD. MA cannot legally sign the interpretation only a nurse, PA, APN or physician can sign. Therefore most practices now refer to the nurses at the health department as the test can be done for $5 or less if there was a verified exposure. $5 is screening fee such as for employment or to join an ambulance corps. The nurses work under the County ID MD protocol & CDC guidelines for interpretation and subsequent referral for additional testing (repeat test, chest X-ray, refer to MD for treatment)[/quote

I would like to thank you also for taking the time to reply to my question. I appreciate it. I've searched different States Board of Healing Arts websites and many say the same as below:

Section 65-2872(g)of the ##### Healing Arts Act states that the following individuals are deemedto not be engaged in the practice of medicine Persons whose professional services are performed under the supervision or by order orreferral from a practitioner who is licensed under this Act.

It is my legal opinion that this language permits physicians to delegate areasonable scope of clinical procedures (including venipuncture andadministration of medication (including intramuscular, intradermal, andsubcutaneous injections), and transmittingthe supervising physician's orders by telephone) to competent andknowledgeable medical assistants working under their direct supervision inoutpatient setting.

I define telephone screening as following physician approved algorithms, decisiontrees, protocols, etc. that do not involve the exercise of independentprofessional judgment or the making of clinical assessments/evaluations.

I define telephone triage as exercisingindependent professional judgment in helping patients. It is my legal opinion that medicalassistants can be delegated telephone screening by the overseeing physician,but not telephone triage.

Procedureswhich constitute the practice of medicine, or which state law specificallyand unambiguously permits only certain licensed allied health careprofessionals to perform, however, may not be delegated to unlicensed personnelsuch as medical assistants.

If I'm understanding, reading a TB test is "practicing medicine". Reading a TB test site is making clinical assessments/evaluations, which is not allowed.

I find it interesting that the answers posted indicate medical assistants are not allowed to read TB tests, but still do in physician offices.

Thank you again

[Julius Seizure]

I wouldnt say that reading a TB test is "practicing medicine". However, I would say that it requires assessment and by that logic, I'm not sure that medical assistants should do it.

However, not all nurses should either. Many nurses are not trained on how to properly read the results. I think that in this instance, more than the job title, it is important for the person reading the results to be specifically trained on what they are assessing.