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School nurse warns of problems administering COVID tests in Sioux City schools
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School nurse warns of problems administering COVID tests in Sioux City schools

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COVID-19 Rapid Test

A COVID-19 rapid test is shown in this March 17. The Sioux City school district plans to purchase 16,000 rapid tests that would be administered to students who experience symptoms of the virus during the school day. 

SIOUX CITY – The Sioux City school district plans to purchase 16,000 rapid COVID-19 tests for students who experience symptoms during the school day. 

But a school nurse is sounding the alarm over the logistics of administering the tests in school buildings.

Nurse Julie Johnson, who oversees 2,200 students at Bryant Elementary and North High School, told the school board Monday there are many hurdles to overcome for nurses to start giving the tests.

Currently, Johnson said there are no written protocols or procedures for the in-school testing. In a clinical setting, Johnson said there are protocols for any procedure.

Asked by board vice chair Monique Scarlett if nurses are prepared to administer the rapid tests, Johnson said no.

Under the district's plans, students exhibiting symptoms of the virus would be sent to a designated “caring room” to visit the school nurse. The nurse or a certified assistant would then call the student’s parents or guardians, who would have to provide both verbal and written permission for the test to be performed at school.

If granted, the nurse would then administer the rapid test, which delivers a positive or negative reading in a few minutes, compared to several days for a more accurate PCR test.

Despite conversations regarding the testing that began publicly in August, Johnson said nurses have not been approached regarding procedures or plans.

The district also does not have enough registered nurses to administer the tests, Johnson said. 

RNs, she said, are not licensed to diagnose or order a diagnostic test. Orders for tests must be done by practitioners, she said.

The school district recently received a clinical Laboratory Improvement Amendments (CLIA) waiver from the Iowa Department of Public Health to perform the tests in its 20 school buildings.

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With the CLIA waiver, school nurses may perform antigen testing if they are trained in specimen collection and conducting the test per manufacturer’s instructions, according to the Center for Disease Control and Prevention.

Johnson said the school has approval to function as a CLIA lab, but has no knowledge on how it would be implemented.

The RNs will be easily trained to administer the tests, Johnson said, but the nurses would have to delegate the procedures to the Certified Nursing Assistants and there are specific steps for delegation of tasks.

Johnson said many of the nurse’s offices do not have the space available to perform the tests.

“Currently, there’ll be several offices that don’t even have the space, don’t have the counter space, don’t have the privacy, don’t have any of the setup that you would need for lab testing,” she said.

The schools have never performed diagnostic testing, including pregnancy tests and drug tests.

Johnson recommended the district partner with community organizations instead.

The school board acknowledged the ESSER III plan Monday night which allows the district administration to move forward with the plans. Items for approval are expected to be brought before the board beginning at the next regular meeting.

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