Is This Function Within My Scope of Nursing Practice?

Carolyn Buppert, MSN, JD

Disclosures

July 20, 2017

Are Your Protocols Legal?

You say you have protocols for giving vaccinations, triage, and patient advice. So, as long as those protocols are written, authorize you to do what you are doing, signed by an individual authorized to delegate authority to you, conform to any state law requirements on protocols, follow the generally accepted standard of care, and don't violate any state law on, say, vaccination protocols, then you should be covered, as long as you follow the protocol.

Here is the process to determine whether you are within scope of practice. First, read your state's nurse practice act to determine your scope of practice. Some Boards of Nursing have algorithms. All have lists of functions. Generally, a nurse may administer vaccinations but is not authorized in the state scope-of-practice law to make the decision about whether a specific patient needs a specific vaccination at that time. If there is no specific authority for a specific act, a nurse will need a protocol or some other form of delegation.

Second, check your state's law for any statutes or regulations that address the specific function you are performing, such as ordering of vaccinations, triaging, or giving medical advice. Third, check your state's law for any regulations generally or specifically addressing nurse protocols. This law may be found in the public health law or the nurse practice act.

Your clinic's or facility's management team should have their attorney go through the process described above to determine whether your state authorizes the protocols you are working under and whether the protocols meet the state's requirements.

Here are some resources on vaccination protocols:

Using Standing Orders for Administering Vaccines: What You Should Know

Suggestions to Improve Your Immunization Services

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