National Nurse Triage Line Project: Legal and Policy Issues (2012)
In collaboration with the Association of the State and Territorial Health officials (ASTHD), the National Association of County & City Health Officials (NACCHO), and the Center for Disease Control and Prevention (CDC), this report assesses legal and policy issues regarding use of nurse triage lines (NTLs) during a pandemic. Materials from a stakeholders meeting in March, 2012 in Atlanta regarding the larger project are available from NACCHO.
NTLs are telephone hotlines staffed by Registered Nurses who can provide essential information, make initial assessments, and issue prescriptions for antiviral medications using established decision support tools. NTLs can improve access to antiviral medications and reduce strain on health care and public health systems during an emergency. A national network of state- or region-based NTLs built on existing telephonic infrastructures may potentially enhance response during a future pandemic event.
The report discusses legal challenges related to: NTL design, professional relationships between NTL staff and callers, standard of care, operationalization before and during declared emergencies, ensuring adequate personnel and appropriate authority, and liability protections. Potential solutions to these challenges are proffered based on interpretations of law and practice and lessons learned from prior emergencies.