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Screening and diagnostic tests & imaging

​Screening and diagnostic tests & imaging are an integral part of prevention, diagnosis, prognosis, stratification of risk, and treatment of disease in nursing practice.

The Screening and Diagnostic Tests and Imaging: Standards, Limits, and Conditions standard outlines the scope of practice, responsibilities, and accountability for nurses when performing or requesting tests. It also outlines when nurses may apply for and use a Medical Services Plan (MSP) practitioner number to request screening and diagnostic tests for communicable disease prevention and management.

What will I learn?

  • Key considerations when requesting or performing tests and imaging.
  • Requirements when requesting tests with an MSP practitioner number for communicable disease prevention and management.

Standards


What to consider

There are a number of considerations related to screening and diagnostic tests & imaging activities:

Controls on practice

The controls on practice is a good place to start when making decisions about nursing activities, including tests and imaging.

There are four levels of regulatory control on a nurse’s practice. Each level, from the bottom to the top, narrows and defines your scope of practice. You must work within the legal and regulatory framework that governs your practice and follow the policies and procedures of your employer.

Legislation and regulatory considerations
  • Am I authorized to request or perform this test? If I am performing the test, am I competent?
  • Which standards, limits, or conditions must I follow? Certain screening and diagnostic tests, such as x-ray, have BCCNM limits and conditions.  Review the Scope of Practice standards—Acting within Autonomous Scope of Practice standard, Acting with a Client-specific order practice standard, and any relevant limits and conditionstomake sure you are practicing within your scope of practice.
Workplace considerations
  • Does my employer authorize me to request or perform this test?
  • Are there policies/processes in place for test follow up and communicating results? For example, who will be responsible for communicating the result to and any follow-up care with the client?
  • Do I have the resources and support needed to safely carry out the test?
  • Are there processes in place for someone to receive and respond to critical results after regular working hours or in my absence?
Nurse competence considerations
  • Am I competent to request or perform the test, interpret, and manage the results?
  • Am I the most appropriate person to determine which tests the client needs or is there someone on the team who is more appropriate?
  • Do I know the appropriate tests to request? Is it based on a nursing diagnosis of a condition?
  • Do I know where to find evidence-based information about testing options?
  • If I am working as a certified practice nurse, do I know how to access the relevant DSTs?
  • What is the potential usefulness of test results, and will they impact my decision making? Does the test provide information that I can’t get from the history, examination or other means?
  • Do I know who to refer to or consult for tests and imaging results outside of my scope of practice or competence? It is your responsibility to consult with the appropriate health-care provider within an appropriate timeframe.
Client considerations
  • Does the test consider the client’s physical, mental, emotional, spiritual, social, and cultural needs?
  • Is the client informed about the test and potential outcomes? Clients should understand what to expect if the results are positive, inconclusive, or negative.
  • Can the client access the test, and are they aware of the risks and costs?

Communicable disease prevention and management

If required in your practice setting, you may request outpatient tests for communicable disease prevention and management. To do so requires a Medical Services Plan (MSP) practitioner number. MSP practitioner numbers are nurse specific and are not to be shared with others.

Only apply for and use an MSP number:

  • with employer approval, 
  • when your employer has processes to mange test results and for nurses to refer to/consult with another health professional regarding tests, and
  • for tests for communicable disease prevention and management. MSP practitioner numbers are not to be used to request tests that are not for communicable disease prevention and management purposes.

More information on MSP practitioner numbers

FAQs

Can a nurse relay test results to a client?

While there aren’t regulatory restrictions on sharing test results with clients, your employer might have policies about when nurses can share test results and any steps you need to follow. Consider if you are the best person to interpret the results and share them with the client. Will you be able to answer questions the client may have about the results or treatment options or is this better handled by another member of the team?

When acting within your autonomous scope of practice you are responsible for sharing test results with the client or referring to another health professional to do this when interpreting the result is outside your competence.

Nurses also need to follow BCCNM’s Privacy and Confidentiality practice standard. If a client wants access to their medical records, follow your employer’s policies on how clients can view their personal health information.

External Resources

Need help or advice?

For further guidance on the Standards of Practice or your professional practice contact us:

900 – 200 Granville St
Vancouver, BC  V6C 1S4
Canada

info@bccnm​.ca
604.742.6200​
​Toll-free 1.866.880.7101 (within Canada only) ​


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