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  • 1.  TB skin tests

    Posted 06-05-2023 11:22

    Does anyone have their Medical Assistants placing and/or reading TB skin tests in their clinic? Does anyone know an authoritative body on this matter? The CDC only says they may be read by "a health care worker trained to read TST results." 

    Thanks!



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    Tyler Fredrick
    Clinical Nurse Consultant
    University Health
    Kansas City, MO
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  • 2.  RE: TB skin tests

    Posted 06-05-2023 13:08

    Hello

    For my state, MAs are allowed to place and measure but they cannot interpret. Since it is not good use of resources utilizing 2 healthcare personnel for one reading, I only allow the nurses to read and interpret with ongoing education. 



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    Kristyl McCray MSN RN-BC
    RN Clinical Director, Education & Prof. Practice
    PIH Health Physicians
    Whittier CA
    (562)698-0811
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    Original Message


  • 3.  RE: TB skin tests

    Posted 06-06-2023 12:13

    We have MAs complete a competency for both intradermal placement and measuring injection site.  Since the reading includes taking a measurement (and MAs are allowed to take other measurements) and we have interpretation guidelines based on the measurement, we do allow them to place and read.

     

     

     

    Danielle Smith, MSN, RN, CNL

    Pronouns: she/her/hers

    Clinical Practice Leader, Primary Care

    Children's Wisconsin

    Cell: 262-989-1999

    childrenswi.org

     

    Please note: My email address is now dsmith2@childrenswi.org

     

     

    This message originates from Children's Wisconsin, and may contain information that is privileged and confidential. It is intended only for the use of the designated recipient. Any review, dissemination, distribution, or copying of this message by anyone other than the intended recipient is prohibited. All personal messages express views solely of the sender, are not to be attributed to Children's Wisconsin, and may not be copied or distributed without this disclaimer. If you have received this message in error, please notify the sender and destroy the original message. Thank you.



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  • 4.  RE: TB skin tests

    Posted 06-06-2023 08:49

    We allow certified medical assistants to place a PPD, once competent. In NJ there must be at least 10 observed placements. They cannot read/interpret results. That is done by the RN

     

    Inger Donohue MSN, RN, CPHQ

    Director of Quality and Clinical Services

    465 South Street, Suite 200

    Morristown, NJ 07962

    P 973 829 4268

    C 862 345 0799

     

     

        

     

    Nothing in life is to be feared, it is only to be understood. Now is the time to understand more, so that we may fear less. (Mme. Marie Curie, 1867-1934)

     

     




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  • 5.  RE: TB skin tests

    Posted 06-06-2023 17:33

    We have actually trained and have competencies in place for lab techs to place the PPD but not read them.  Only RN's read.  We did that because maintaining competency for all the MA's on something they didn't do very often got to be too cumbersome.  



    ------------------------------
    Rebekah Sherman
    Director of Nursing
    La Clinica de Valle
    Medford OR
    (541)221-3040
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    Original Message


  • 6.  RE: TB skin tests

    Posted 06-07-2023 15:43
    I know of providers who have the cma provide and read the TB skin test. I do not and will not have a PPD read by a cma. In my experience, it is hard enough to get a licensed person to do it correctly.  One more thing to be researched for comparative patient outcomes. I have cms's who I have loved working with, but I have sincere reservations about broadening their scope of practice just because they have 2 hands and 2 feet.  

    First, for those who know the 10-patient competency, who is responsible for signing off on the competency? The nurse who has delegated this to an unlicensed person or the physician to whom the cma role is bound in most states. 

    I have the understanding that the cma may read a "negative result." Anything other than negative (nothing to see where) requires an assessment. For those of you who may allow the cma to "measure" the site; is the cam trained to recognize erythema on different skin tones and are they able to "assess for an induration" which is the only thing that should be measured if the result is positive.  

    ---------------

     

    Aleesa M Mobley PhD APN  (she/her/hers) Why Pronouns Matter

    Assistant Professor - Clerkship Director [Pain Management/Substance Use Disorder]

    Physical Medicine & Rehabilitation - Neuro Musculoskeletal Institute 

    Lippincott Procedures: Subject Matter Expert - Wolters Kluwer Publishing


    Rowan Medicine Bldg., 42 E. Laurel Rd, Ste 1700, Stratford New Jersey 08084 

    T: 856-566-7010 | F: 856-566-6956| C: 856-230-1229 

    mobley@rowan.edu | som.rowan.edu 


    Learning is not attained by chance, it must be sought for with ardor and attended to with diligence [Abigail Adams (1744 - 1818), 1780].



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  • 7.  RE: TB skin tests

    Posted 06-07-2023 15:48

    All excellent points.  I will be reviewing the competency in depth and working with the RN clinical teams.  I believe this would only cause concern at one site due to not having a full time RN on site.

     

    Thanks for the important discussion!

    Danielle

     

    Danielle Smith, MSN, RN, CNL

    Pronouns: she/her/hers

    Clinical Practice Leader, Primary Care

    Children's Wisconsin

    Cell: 262-989-1999

    childrenswi.org

     

    Please note: My email address is now dsmith2@childrenswi.org

     

     

    This message originates from Children's Wisconsin, and may contain information that is privileged and confidential. It is intended only for the use of the designated recipient. Any review, dissemination, distribution, or copying of this message by anyone other than the intended recipient is prohibited. All personal messages express views solely of the sender, are not to be attributed to Children's Wisconsin, and may not be copied or distributed without this disclaimer. If you have received this message in error, please notify the sender and destroy the original message. Thank you.



    Original Message


  • 8.  RE: TB skin tests

    Posted 06-07-2023 15:54

    Agree on all accounts, Aleesa

     

    Of course too a TB test "reading" starts with an accurate placement. I have done many over the years and it can be tricky to get a true/"worthy" wheal. Are all of those administering assuring this is obtained? If not, the whole process in null.

     

    Thanks as always for your insightful feedback!

     

    Deb

     




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