National Assessment of Nurse Practice Laws for the Development of Triage Lines

The public health issue: In 2011, the Centers for Disease Control and Prevention, in partnership with the Association of State and Territorial Health Officials and the National Association of County and City Health Officials, began to investigate the feasibility and acceptability of developing a national network of triage lines that would be called on in the event of a national emergency (e.g. a pandemic).

This project, called Flu on Call™, emerged from lessons learned during the 2009-2010 H1N1 influenza pandemic, at which time one state and several local health departments established nurse triage lines (NTLs) to provide information to the public to alleviate the medical surge on the healthcare system. The goals of Flu on Call™ are to improve access to antiviral medication, reduce the need for face-to-face provider encounters, and reduce the surge on medical facilities during an influenza pandemic.

Our contribution to the solution: PHMC’s legal and public health researchers from the Research & Evaluation Group and the National Nursing Centers Consortium aid in this critical national effort by conducting a 50-state assessment of nurse practice laws related to expanding the scope of practice during an emergency. The team is also investigating the use of triage lines and Medical Reserve Corps volunteers in a public health emergency; conducting case studies of existing NTLs; and participating in the evaluation of a Flu on Call™ demonstration project. NurseAdvice New Mexico (NANM) was found to be a unique example of a year-round NTL and was selected as a case study. Researchers analyzed key informant interviews with NANM leadership, staff and other stakeholders; population datasets; and NANM operational documents. Our team also conducted a literature review, finding that NANM increases access to healthcare to New Mexico residents, has evidence of cost savings, provides critical surge capacity during public health emergencies, and is a potentially replicable care delivery model for other states and communities.