New York Codes, Rules and Regulations
Title 8 - EDUCATION DEPARTMENT
Chapter II - Regulations of the Commissioner
Subchapter B - Regulation of Professions
Part 64 - Nursing
Section 64.7 - Administration of immunizations, emergency treatment of anaphylaxis, tuberculosis tests, human immunodeficiency virus (HIV) tests, opioid related overdose treatments, hepatitis C tests and screening for syphilis, gonorrhea, COVID-19, influenza and/or chlamydia infections pursuant to non-patient specific orders and protocols

(c) immunizing agents against an infectious disease that causes an epidemic or a community wide outbreak, provided that such immunizing agents are administered as part of a public health program established by the Commissioner of the Department of Health, a County Commissioner of Health, or a County Public Health Director to immunize persons against the infectious disease during the epidemic or community outbreak of the infectious disease;

(d) additional immunizing agents approved by resolution of the Board of Regents upon recommendation by the commissioner that such additional immunization agents are safe and effective immunization agents for registered professional nurses to administer to patients, pursuant to a non-patient specific order and protocol as prescribed in this section, after consideration of the recommendations of State and/or nationwide authorities that evaluate the effectiveness and safety of immunization agents, including but not limited to the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services. Such additional immunization agents, which are not specifically enumerated in this subparagraph, may be removed by resolution of the Board of Regents, upon recommendation of the commissioner that such immunization agents are not safe and effective immunization agents for registered professional nurses to administer to patients, pursuant to a non-patient specific order and protocol as prescribed in this section, after consideration of the recommendations of State and/or nationwide authorities that evaluate the effectiveness and safety of immunization agents, including but not limited to the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services; and

(e) vaccines that are fully approved or authorized for emergency use by the federal Food and Drug Administration to provide immunity against COVID-19 and administered in accordance with applicable federal Food and Drug Administration requirements and recommendations.

(a) the name, license number and signature of the licensed physician or certified nurse practitioner who orders or prescribes the non-patient specific order and protocol;

(b) the name of the specific immunizing agent(s) to be administered;

(c) a protocol for administering the ordered immunizing agent(s) or a specific reference to a separate written protocol for administering the ordered immunizing agent(s), which shall meet the requirements of subparagraph (ii) of this paragraph;

(d) the period of time that the order is effective, including the beginning and ending dates;

(e) a description of the group(s) of persons to be immunized, including the age range of such persons;

(f) the name and license number of the registered professional nurse(s) authorized to execute the non-patient specific order and protocol to administer the immunizing agent(s); or the name of the entity that employs or contracts with registered professional nurses to execute the non-patient specific order and protocol, provided that the registered professional nurse(s) execute the non-patient specific order and protocol only in the course of such employment or pursuant to such contract and provided further that the entity is legally authorized to employ or contract with registered professional nurses to provide nursing services.

(a) each potential recipient is assessed, pursuant to criteria in the protocol, for conditions that would qualify or preclude him or her from receiving the ordered immunizing agent(s);

(b) the potential recipient, or when the potential recipient lacks capacity to consent, a person authorized pursuant to law to consent to health care for the potential recipient, receives federally required vaccine information, such as vaccine information statements, if applicable, and instructions on addressing adverse reactions to the vaccine;

(c) informed consent for administering the ordered immunizing agent(s) has been obtained, pursuant to the criteria in the protocol, from the recipient, or when the recipient lacks capacity to consent, a person authorized pursuant to law to consent to health care for the recipient;

(d) the administration of the ordered immunizing agent(s) is documented, including the recipient's name, date of administration, address of administration, administering nurse, immunization agent(s), manufacturer(s), lot number(s), in accordance with criteria in the protocol and that documentation relating to the immunizing agent(s) is maintained in accordance with section 29.2(a)(3) of this Title;

(e) the recipient, or when the recipient lacks capacity to consent, a person authorized pursuant to law to consent to health care for the recipient, receives a certificate of immunization with the recipient's name, date of administration, address of administration, administering nurse, immunization agent(s), manufacturer(s), and lot number(s). With the consent of the recipient or a person authorized to consent for the recipient, the registered professional nurse shall communicate this information to the recipient's primary health care provider;

(f) adverse outcomes resulting from the administered immunizing agent(s) shall be reported to the United States Department of Health and Human Services, as may be required by Federal Law; and

(g) immunizing agents administered to recipients are reported to the Department of Health or the New York City Department of Health and Mental Hygiene, as may be required by law.

(a) the specific anaphylaxis treatment agents that the registered professional nurse(s) is permitted to administer;

(b) the period of time that the order is effective, including the beginning and end date;

(c) the name and license number of the registered professional nurse(s) authorized to administer the anaphylaxis treatment agent(s) pursuant to the order; or the name of the entity that is legally authorized to employ or contract with registered professional nurses to provide nursing services with whom registered professional nurses who are not individually named are employed or under contract to administer the prescribed anaphylaxis treatment agent(s) pursuant to the order;

(d) in instances in which the registered professional nurses are not individually named in the order, but are identified as employed or under contract with an entity that is legally authorized to employ or contract with registered professional nurses to provide nursing services, the order shall contain a statement limiting the registered professional nurses to administering anaphylaxis treatment agents only in the course of such employment or pursuant to such contract; and

(e) the name, license number, and signature of the licensed physician or certified nurse practitioner who has issued the order.

(a) Each registered professional nurse shall ensure that a record of all persons to whom they have administered an anaphylaxis treatment agent, including but not limited to: the recipient's name, date, address of administration, administering nurse, anaphylaxis treatment agent, manufacturer, and lot number, is recorded and maintained in accordance with section 29.2(a)(3) of this Title.

(b) The registered professional nurse shall contact the local emergency medical services system following the administration of the anaphylaxis treatment agent, or shall ensure that equivalent follow-up care is provided through other arrangements.

(c) The registered professional nurse shall report to the local emergency medical system or other provider of equivalent follow-up care information concerning the administration of the anaphylaxis treatment agent, including but not limited to: when it was administered, the dosage, strength, and route of administration. The registered professional nurse shall also report such information to the patient's primary care provider if one exists, unless the patient is unable to communicate the identity of his or her primary care provider.

(a) the name, license number and signature of the licensed physician or certified nurse practitioner who orders or prescribes the non-patient specific order and protocol;

(b) the name of the specific tuberculosis tests to be administered;

(c) a protocol for administering the ordered tuberculosis tests or a specific reference to a separate written protocol for administering the ordered tuberculosis tests, which shall meet the requirements of subparagraph (ii) of this paragraph;

(d) the period of time that the order is effective, including the beginning and ending dates;

(e) a description of the group(s) of persons to be treated; and

(f) the name and license number of the registered professional nurse(s) authorized to execute the non-patient specific order and protocol to administer the tuberculosis tests; or the name of the entity that employs or contracts with registered professional nurses to execute the non-patient specific order and protocol, provided that the registered professional nurse(s) execute the non-patient specific order and protocol only in the course of such employment or pursuant to such contract and provided further that the entity that is legally authorized to employ or contract with registered professional to provide nursing services.

(a) each potential recipient is assessed, pursuant to criteria in the protocol, for conditions that would qualify or preclude him or her from receiving the ordered tuberculosis tests;

(b) informed consent for administering the ordered tuberculosis tests or disclosing the tuberculosis tests results to a third party (if applicable) has been obtained pursuant to the criteria in the protocol from the recipient, or when the recipient lacks capacity to consent, a person authorized pursuant to law to consent to health care for the recipient;

(c) any tuberculosis test results are disclosed and any recommendations for follow up care are made in accordance with the criteria in the protocol; and

(d) the administration of the ordered tuberculosis tests and the test results are documented in the recipient's medical record in accordance with the criteria in the protocol and that documentation relating to tuberculosis testing is maintained in accordance with section 29.2(a)(3) of this Title;

(e) additional requirements for tuberculin skin tests. If the non-patient specific order authorizes a tuberculin skin tests, the written protocol shall, in addition to the foregoing:

(a) identification of the HIV test;

(b) the period of time that the order is effective, including the beginning and ending dates;

(c) the name and license number of the registered professional nurse(s) authorized to execute the order to administer the HIV test; or the name of the entity that is legally authorized to employ or contract with registered professional nurses to provide nursing services with whom registered professional nurses who are not individually named are employed or under contract to execute the order to administer the HIV test;

(d) in instances in which registered professional nurses are not individually named in the order, but are identified as employed or under contract with an entity that is legally authorized to employ or contract with registered professional nurses to provide nursing services, the order shall contain a statement limiting registered professional nurses to execute the order to administer HIV tests only in the course of such employment or pursuant to such contract; and

(e) the name, license number, and signature of the licensed physician or certified nurse practitioner that has issued the order.

(a) the registered professional nurse shall ensure that each potential recipient is assessed for conditions that would preclude HIV testing and ensure that each recipient's record of the HIV test with manufacturer and lot number or a potential recipient's refusal to be tested is documented in accordance with section 29.2(a)(3) of this Title;

(b) the registered professional nurse shall execute the order to administer an HIV test in accordance with applicable State laws and regulations, including but not limited to, article 27-F of the Public Health Law and 10 NYCRR Part 63;

(c) the registered professional nurse shall certify that he/she obtained the written, informed consent of the recipient, or when the recipient lacks capacity to consent, a person authorized pursuant to law to consent to health care for such individual, prior to ordering the performance of the HIV test. Informed consent shall include pre-test counseling to the recipient, or if the recipient lacks capacity to consent, a person authorized pursuant to law to consent to health care for such individual. The written informed consent and the pre-test counseling shall be obtained and conducted in accordance with article 27-F of the Public Health Law and 10 NYCRR Part 63;

(d) a physician or nurse practitioner who issues a non-patient specific order for HIV testing shall retain responsibility for communication of a confirmatory, positive HIV test result to the recipient, or when the recipient lacks capacity to consent, a person authorized pursuant to law to consent to health care for such individual. A registered professional nurse is not authorized to deliver a final confirmatory HIV positive test result through a non-patient specific order. A registered professional nurse may only deliver a confirmatory, positive HIV test result through a patient specific order as directed by the treating physician or nurse practitioner;

(e) the registered professional nurse shall, upon request, ensure that the recipient, or when the recipient lacks capacity to consent, a person authorized pursuant to law to consent to health care for such individual, is provided with a signed certificate of HIV testing and results, with the recipient's name, date of the test, address where the test was administered, the name of the administering nurse, manufacturer and product lot number;

(f) with the consent of the recipient or when the recipient lacks capacity to consent, a person authorized pursuant to law to consent to health care for such individual, and with an appropriate authorization for the release of confidential HIV information, the registered professional nurse shall ensure that this information is communicated to the recipient's primary health care provider if one exists in accordance with the requirements of article 27-F of the Public Health Law and 10 NYCRR Part 63; and

(g) each registered professional nurse shall ensure that a record of all persons so tested including the recipient's name, date of the test, address where the test was administered, administering nurse, test results, manufacturer, lot numbers and such other information as may be necessary pursuant to the protocol is recorded and maintained in accordance with section 29.2(a)(3) of this Title and article 27-F of the Public Health Law and 10 NYCRR Part 63.

(a) the name, license number and signature of the licensed physician or certified nurse practitioner who orders or prescribes the non-patient specific order and protocol;

(b) the name, dose and route of administration of the drug to be administered to treat opioid related overdose;

(c) a protocol for administering the ordered opioid related overdose treatment or a specific reference to a separate written protocol for administering the ordered opioid related overdose treatment, which shall meet the requirements of subparagraph (ii) of this paragraph;

(d) the period of time that the order is effective, including the beginning and ending dates;

(e) a description of the group(s) of persons to be treated; and

(f) the name and license number of the registered professional nurse(s) authorized to execute the non-patient specific order and protocol to administer the opioid related overdose treatment; or the name of the entity that employs or contracts with registered professional nurses to execute the non-patient specific order and protocol, provided that the registered professional nurses execute the non-patient specific order and protocol only in the course of such employment or pursuant to such contract and provided further that the entity is legally authorized to employ or contract with registered professional nurses to provide nursing services.

(a) each potential recipient is assessed, pursuant to criteria in the protocol, for conditions that would qualify or preclude him or her from receiving the ordered opioid related overdose treatment;

(b) consent to administer treatment is obtained, pursuant to criteria in the protocol, if the potential recipient is capable of providing it;

(c) the opioid related overdose treatment is documented, pursuant to criteria in the protocol, and includes the name and dose of drug administered, the date, time and location of the treatment, the recipient's name and the administering registered professional nurse's name and this medical documentation relating to opioid related overdose treatment is maintained in accordance with paragraph 29.2(a)(3) of this Title; and

(d) when opioid related overdose treatment is administered outside of a general hospital, the recipient of the treatment is transferred to a hospital for follow-up care to the extent possible along with documentation describing the opioid related overdose treatment that was administered, in accordance with criteria in the protocol.

(a) the name, license number and signature of the licensed physician or certified nurse practitioner who orders or prescribes the non-patient specific order and protocol;

(b) the name of the specific hepatitis C tests to be administered;

(c) a protocol for administering the ordered hepatitis C tests or a specific reference to a separate written protocol for administering the ordered hepatitis C tests, which shall meet the requirements of subparagraph (ii) of this paragraph;

(d) the period of time that the order is effective, including the beginning and ending dates;

(e) a description of the group(s) of persons to be tested; and

(f) the name and license number of the registered professional nurse(s) authorized to execute the non-patient specific order and protocol to administer the hepatitis C tests; or the name of the entity that employs or contracts with registered professional nurses to execute the non-patient specific order and protocol, provided that the registered professional nurses execute the non-patient specific order and protocol only in the course of such employment or pursuant to such contract and provided further that the entity is legally authorized to employ or contract with registered professional nurses to provide nursing services.

(a) each potential recipient is assessed, pursuant to criteria in the protocol, for conditions that would qualify or preclude him or her from receiving the ordered hepatitis C tests;

(b) informed consent for administering the ordered hepatitis C tests or disclosing the hepatitis C test results to a third party (if applicable) has been obtained pursuant to the criteria in the protocol from the recipient, or when the recipient lacks capacity to consent, a person authorized pursuant to law to consent to health care for the recipient;

(c) confirmatory, positive hepatitis C test results are not disclosed to the test recipient or the recipient's authorized representative by the registered professional nurse without a patient specific order from a licensed physician, licensed physician assistant or certified nurse practitioner; and

(d) the administration of the ordered hepatitis C test(s) is documented in the recipient's medical record in accordance with criteria in the protocol and that documentation relating to the hepatitis C testing is maintained in accordance with section 29.2(a)(3) of this Title.

(a) the name, license number and signature of the licensed physician or certified nurse practitioner who orders or prescribes the non-patient specific order and protocol;

(b) the name of the specific laboratory or point of care test(s) or assessment procedures to be administered;

(c) a protocol for administering the ordered screening for syphilis, gonorrhea and/or chlamydia infections or a specific reference to a separate written protocol for administering the ordered screening for syphilis, gonorrhea and/or chlamydia, which shall meet the requirements of subparagraph (ii) of this paragraph;

(d) the period of time that the order is effective, including the beginning and ending dates;

(e) a description of the group(s) of persons to be screened; and

(f) the name and license number of the registered professional nurse(s) authorized to execute the non-patient specific order and protocol to screen for syphilis, gonorrhea and/or chlamydia infections; or the name of the entity that employs or contracts with registered professional nurses to execute the non-patient specific order and protocol, provided that the registered professional nurses execute the non-patient specific order and protocol only in the course of such employment or pursuant to such contract and provided further that the entity is legally authorized to employ or contract with registered professional nurses to provide nursing services.

(a) each potential recipient is assessed, pursuant to criteria in the protocol, for conditions that would qualify or preclude him or her from receiving the ordered screening tests for syphilis, gonorrhea and/or chlamydia infections;

(b) informed consent for administering the ordered screening for syphilis, gonorrhea and/or chlamydia has been obtained from the recipient pursuant to the criteria in the protocol, or when the recipient lacks capacity to consent, from a person authorized pursuant to law to consent to health care for the recipient;

(c) positive test results for syphilis, gonorrhea and/or chlamydia infections are not disclosed to the test recipient or the recipient's authorized representative by the registered professional nurse without a patient specific order from a licensed physician, licensed physician assistant or certified nurse practitioner; and

(d) the administration of the ordered screening for syphilis, gonorrhea and/or chlamydia is documented in the recipient's medical record in accordance with criteria in the protocol and that documentation relating to the screening for syphilis, gonorrhea and/or chlamydia is maintained in accordance with section 29.2(a)(3) of this Title.

(a) the name, license number and signature of the licensed physician or certified nurse practitioner who orders or prescribes the nonpatient specific order and protocol;

(b) the name of the specific COVID-19 or influenza test to be administered;

(c) a protocol for administering the ordered COVID-19 or influenza test or a specific reference to a separate written protocol for administering the ordered test, which shall meet the requirements of subparagraph (ii) of this paragraph;

(d) the period of time that the order is effective, including the beginning and ending dates;

(e) a description of the group(s) of persons to be tested; and

(f) the name and license number of the registered professional nurse(s) authorized to execute the non-patient specific order and protocol to administer the ordered COVID-19 or influenza test, or the name of the entity that employs or contracts with registered professional nurse(s) to execute the non-patient specific order and protocol, provided that the registered professional nurse(s) execute the non-patient specific order and protocol only in the course of such employment or pursuant to such contract and the entity is legally authorized to employ or contract with registered professional nurses to provide nursing services.

(a) each potential recipient is assessed, pursuant to criteria in the protocol, for conditions that would qualify or preclude him or her from receiving the ordered test;

(b) informed consent for administering the ordered test or disclosing the test results to a third party (if applicable) has been obtained pursuant to the criteria in the protocol from the recipient, or when the recipient lacks capacity to consent, a person authorized pursuant to law to consent to health care for the recipient;

(c) positive diagnostic test results shall be disclosed to the test recipient, or the recipient's authorized representative, by the registered professional nurse as specifically authorized by the protocol or pursuant to a patient specific order from a licensed physician, licensed physician assistant, or certified nurse practitioner; and

(d) the administration of the ordered test(s) is documented in the recipient's medical record in accordance with criteria in the protocol. Such documentation shall be maintained in accordance with section 29.2(a)(3) of this Title.