The following is a Summary of discussion regarding glucagon administration to students in the school setting by unlicensed personnel and role of nursing in delegation of task.
The NH Board of Nursing met on March 21, 2013 for the regularly scheduled board meeting. An hour of discussion occurred during that time to address the role of nurse's oversight of unlicensed personnel who provide glucagon in an emergent situation. Representatives from the School Nurses Association, The Diabetes Association (which also included a diabetic educator and concerned parent of diabetic children), and the sponsor for HB 494 were present to speak to the board regarding the delegation wording that addresses a "stable client". A letter from the Board of Education that was presented in response to HB 494 was also presented to the group. After the discussion, the board opined the following:
The administration of glucagon by a trained non-licensed personnel does not come under the delegation rules as written. Delegation of a task to unlicensed personnel requires that the nurse can assess the situation before and after the task is completed. In this case, if a student needed the glucagon, it would not be delegated to another person. The nurse would administer the medication to the student.
The board opined that the plan for the administration of glucagon in the absence of a nurse would be part of the student's individual medical care plan and would be a collaborative effort between the provider, the school nurse, the parents and the school administration to identify appropriate personnel for training. The training, ideally, would be provided either by the nurse or by personnel from the American Diabetes Association following a course curriculum that addresses this issue. This reflects the tenets of HB 494 which is currently being reviewed in committee.
New Hampshire Board of Nursing
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