20:48:04.01:16.  Written protocol required for the delegation of insulin administration by the subcutaneous route to a nursing assistant. Before a registered nurse may delegate insulin administration by the subcutaneous route to a nursing assistant, the registered nurse must develop a written protocol. The written protocol must include the following requirements:

    (1) The nursing assistant shall complete a five hour board-approved training in the following areas:

        (a)  Diabetes basics;

        (b)  Hypoglycemia;

        (c)  Hyperglycemia;

        (d)  Blood glucose monitoring;

        (e)  Glucagon administration;

        (f)  Insulin types and methods of administration;

        (g)  Nutrition and physical activity;

        (h)  Documentation; and

        (i)  Standard precautions;

    (2)  The nursing assistant shall pass a written examination on the areas listed in subdivision (1). A passing score of 85 percent is required on the test. If the nursing assistant fails the test, the nursing assistant may retake the test one time. If the nursing assistant fails the retake, additional instruction is required before further testing is allowed;

    (3)  The nursing assistant shall complete a minimum of five hours of clinical or laboratory instruction, including the demonstration of individual competence utilizing a board-approved competency checklist, in the following areas:

        (a)  Blood glucose monitoring;

        (b)  Insulin administration;

        (c)  Glucagon administration;

        (d)  Carbohydrate counting and diet management; and

        (e)  Standard precautions;

    (4)  The registered nurse shall meet in-person with the nursing assistant, after completion of the requirements in subdivisions (1), (2), and (3), during a client’s mealtime at least two times per week in the first four weeks to consult with the nursing assistant and to evaluate competence;

    (5)  The registered nurse must be available by electronic communication at all mealtimes; and

    (6)  The registered nurse shall complete an annual review of the nursing assistant’s competence in each area identified in subdivision (3).

    Source: 41 SDR 12, effective July 31, 2014; 49 SDR 51, effective November 27, 2022.

    General Authority: SDCL 13-33A-2, 36-9-21.

    Law Implemented: SDCL 13-33A-1, 36-9-3, 36-9-21.