Damien Bible, 26, was jailed last year after being found guilty of engaging in sexual activity with a child at a clinic in Bolton.
Now an internal report has discovered how Bible was allowed to continue working with children despite repeated alarms.
A report into the case revealed concerns were raised about Bible's behaviour, conduct and language on four separate occasions before he tested the girl.
He was suspended when she reported what happened but re-instated as a health care assistant after a month.
Further complaints were then received and Bible was suspended again for harassment.
The report, published by Bolton Primary Care Trust, revealed staff could be disciplined as a result.
The trust said there was a 'possible case' for general misconduct action against 'specific' employees for acting negligently by not taking action when concerns about Bible first emerged. Investigations have already started.
The report, revealed in later editions of yesterday's M.E.N, said: "The details of the report indicate that there is a possible case for disciplinary action to be taken against specific employees for general misconduct on the grounds of a failure to observe policies or negligence in job performance.
Disciplinary procedure
"In accordance with the disciplinary procedure, NHS Bolton will instigate appropriate investigations to establish the facts on which to base possible further action under the policy."
Bible, of Daubhill, Bolton, was jailed for three and a half years in December after he was found guilty by a jury at Bolton Crown Court of engaging in sexual activity with a child.
The court was told that the nurse, who was working in A&E at the Royal Bolton Hospital at the time, carried out the chlamydia test in January last year to satisfy his own `perverted lust'.
He had no accreditation to perform the test at the Parallel Clinic in Bolton, a drop-in centre for youngsters, and two of the girl's friends were present at the time.
The report detailed sweeping security reforms and independent consultants will also be employed to carry out a separate external review of the trust's systems later this year.
It revealed concerns were first raised about Bible's conduct from August 2006.
Issues were raised about his language, fitness to work, conduct on a training exercise and harassment.
Two trust 'whistle-blowers' also told bosses that he shouldn't have been allowed to return to work after he was suspended for the first time, the report revealed.
It added that 11 employees were interviewed before he was suspended for harassment.
That suspension prompted an in-depth investigation involving police and Bible was arrested and charged in connection with the test on the girl.
The report reveals policies on managing and recording concerns raised about staff will be tightened and staff will be required to seek early professional advice when any emerge.
Policies regarding references and internal interviews will be strengthened and disciplinary policies will be changed to focus on specific allegations before anything else.
The trust's `whistle-blowing' policies will also change to secure confidentialities. Extra training will also be introduced with specific reference to child safeguard policies.
Special `cards' with procedures printed on them for easy reference will be issued and a specific policy for managing allegations of professional abuse launched.
Chaperone policies will also change to ban children from accompanying other children for sexual health tests in the majority of cases.
The trust said the changes recommended would `strengthen NHS Bolton systems of safeguarding adults and children and minimise the risk of harm to patients and staff in the future.'
Bosses apologised to the girl's family and praised the staff who `persisted' in raising concerns about Bible, adding: "They have made an important contribution to protecting young people in Bolton." Tweet
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