Does a registered nurse require an order to perform Clinical Laboratory Improvement Amendments (CLIA) FDA tests such as a human chorionic gonadotropin (hCG), urine dipstick, strep throat screening, occult blood screening, or blood glucose capillary test?

It is not within the scope of the registered nurse to make a medical diagnosis – CLIA waived tests are considered screening (not diagnostic tests). The nursing laws and rules allow the competent and appropriately trained registered nurse to perform tests such as a human chorionic gonadotropin (hCG), urine dipstick, strep throat screening, occult blood screening, blood glucose capillary tests or other CLIA approved waiver under the CLIA criteria. An order is required from an authorized health care practitioner to perform any activity that involves puncturing the skin as this is considered part of the definition of the practice of medicine. The CLIA waived tests that do not involve puncturing the skin may be initiated by a registered nurse without an order from an authorized health care practitioner. The registered nurse should use the Scope of Practice Decision Tree to determine if these activities are within the nurse’s legal and individual scope of practice.