BON Q&A on Antigen Testing
We received the following guidance from the Virginia Board of Nursing (BON) regarding antigen testing at facilities:
Q: The federal government will be distributing point-of-care (POC) antigen tests (BinaxNOW) to states; are there any scope of practice issues with placing these assays in settings where there isn’t always a licensed healthcare provider? Does a certain level provider have to administer such tests?
A: While this question cites the BinaxNOW test, other POC tests (BD and Quidel) do not alter our collective opinion.
Virginia Code allows a Board of Medicine licensee to delegate functions that are nondiscretionary and that do not require the exercise of professional judgement to trained, but unlicensed, individuals. This is the applicable Code section:
§ 54.1-2901. Exceptions and exemptions generally
- The provisions of this chapter shall not prevent or prohibit:
- Any practitioner licensed or certified by the Board from delegating to personnel supervised by him, such activities or functions as are nondiscretionary and do not require the exercise of professional judgment for their performance and which are usually or customarily delegated to such persons by practitioners of the healing arts, if such activities or functions are authorized by and performed for such practitioners of the healing arts and responsibility for such activities or functions is assumed by such practitioners of the healing arts;
Licensed practitioners in this case would need to have prescriptive authority as the BinaxNOW is by prescription only. Hence delegators could include MDs, DOs, Podiatrists, PAs, and NPs. The delegating authority could be a practicing provider, a local health director, or even Dr. Oliver. The keys are that the delegating authority must supervise the personnel and assure that they are trained and competent.
Non-licensed individuals (for example CNAs and MAs) could be trained on the BinaxNOW and be assessed for competency. (Abbott does provide training modules, a proficiency written test, and way to document training.)
