National Nurse Triage Line Project: A Review of Legal and Policy Issues
Part of a collaboration with ASTHO, NACCHO, and CDC examining antiviral management and distribution systems and processes, this report assesses legal and policy issues regarding use of nurse triage lines (NTLs) during a pandemic. Materials from a stakeholders meeting held March 20, 2012 in Atlanta regarding the larger project may be found here.
NTLs are telephone hotlines staffed by Registered Nurses, who can provide essential information, make initial assessments, and potentially even 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.
They were used successfully by some jurisdictions during the 2009/2010 H1N1 pandemic, and 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 providing liability protections.
The report also provides potential solutions to these challenges based on interpretations of law and practice and lessons learned from prior emergencies.