<html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><title></title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.sfe97768a-d468-464a-beb0-03f9567233a1P0 { margin-top: 0; margin-bottom: 0; margin-left: 0; margin-right: 0; text-indent: 0.00in; text-align: justify; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; } span.sfe97768a-d468-464a-beb0-03f9567233a1C0 { color: black; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.sfe97768a-d468-464a-beb0-03f9567233a1C0-000000 { color: #0000FF; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.sfe97768a-d468-464a-beb0-03f9567233a1C0-000001 { color: black; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.sfe97768a-d468-464a-beb0-03f9567233a1000002 { color: black; background: white; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.sfe97768a-d468-464a-beb0-03f9567233a1C0-000003 { color: #0000FF; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="sfe97768a-d468-464a-beb0-03f9567233a1P0"><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0">    </span><a href="https://sdlegislature.gov/Rules?Rule=20:48:04.01:16"><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0-000000">20:48:04.01:16</span></a><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0-000001">.  Written protocol required for the delegation of insulin administration by the subcutaneous route to a nursing assistant.</span><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0"> </span><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0">Before a registered nurse may delegate</span><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0"> insulin administration by the subcutaneous route to </span><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0">a nursing assistant,</span><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0"> the registered nurse</span><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0"> must develop a written protocol</span><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0">. The </span><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0">written protocol must include the following requirements</span><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0">:</span></p><p dir="ltr" class="sfe97768a-d468-464a-beb0-03f9567233a1P0"><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1000002"> </span></p><p dir="ltr" class="sfe97768a-d468-464a-beb0-03f9567233a1P0"><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0">    (1) </span><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0">The nursing assistant shall</span><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0"> </span><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0">c</span><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0">omple</span><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0">te</span><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0"> a five hour </span><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0">b</span><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0">oard</span><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0">-</span><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0">approved training in the following areas:</span></p><p dir="ltr" class="sfe97768a-d468-464a-beb0-03f9567233a1P0"><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1000002"> </span></p><p dir="ltr" class="sfe97768a-d468-464a-beb0-03f9567233a1P0"><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0">        (a)  Diabetes basics;</span></p><p dir="ltr" class="sfe97768a-d468-464a-beb0-03f9567233a1P0"><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0">        (b)  Hypoglycemia;</span></p><p dir="ltr" class="sfe97768a-d468-464a-beb0-03f9567233a1P0"><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0">        (c)  Hyperglycemia;</span></p><p dir="ltr" class="sfe97768a-d468-464a-beb0-03f9567233a1P0"><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0">        (d)  Blood glucose monitoring;</span></p><p dir="ltr" class="sfe97768a-d468-464a-beb0-03f9567233a1P0"><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0">        (e)  Glucagon administration;</span></p><p dir="ltr" class="sfe97768a-d468-464a-beb0-03f9567233a1P0"><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0">        (f)  Insulin types and methods of administration;</span></p><p dir="ltr" class="sfe97768a-d468-464a-beb0-03f9567233a1P0"><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0">        (g)  Nutrition and physical activity;</span></p><p dir="ltr" class="sfe97768a-d468-464a-beb0-03f9567233a1P0"><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0">        (h)  Documentation;</span><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0"> and</span></p><p dir="ltr" class="sfe97768a-d468-464a-beb0-03f9567233a1P0"><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0">        (i)  </span><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0">Standard</span><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0"> precautions;</span></p><p dir="ltr" class="sfe97768a-d468-464a-beb0-03f9567233a1P0"><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1000002"> </span></p><p dir="ltr" class="sfe97768a-d468-464a-beb0-03f9567233a1P0"><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0">    (2)  </span><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0">The nursing assistant shall pass a </span><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0">written examination</span><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0"> on the areas listed in subdivision (1)</span><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0">. A passing score of 85 percent is required on the test</span><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0">.</span><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0"> </span><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0">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</span><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0">;</span></p><p dir="ltr" class="sfe97768a-d468-464a-beb0-03f9567233a1P0"><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1000002"> </span></p><p dir="ltr" class="sfe97768a-d468-464a-beb0-03f9567233a1P0"><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0">    (3)  </span><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0">The nursing assistant shall complete a </span><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0">minimum of five hours of clinical or laboratory instruction</span><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0">,</span><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0"> including the demonstration of individual competence utilizing a </span><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0">b</span><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0">oard</span><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0">-</span><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0">approved competency checklist</span><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0">,</span><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0"> in the following areas:</span></p><p dir="ltr" class="sfe97768a-d468-464a-beb0-03f9567233a1P0"><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1000002"> </span></p><p dir="ltr" class="sfe97768a-d468-464a-beb0-03f9567233a1P0"><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0">        (a)  Blood glucose monitoring;</span></p><p dir="ltr" class="sfe97768a-d468-464a-beb0-03f9567233a1P0"><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0">        (b)  Insulin administration;</span></p><p dir="ltr" class="sfe97768a-d468-464a-beb0-03f9567233a1P0"><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0">        (c)  Glucagon administration;</span></p><p dir="ltr" class="sfe97768a-d468-464a-beb0-03f9567233a1P0"><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0">        (d)  Carbohydrate counting</span><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0"> and </span><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0">diet management;</span><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0"> and</span></p><p dir="ltr" class="sfe97768a-d468-464a-beb0-03f9567233a1P0"><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0">        (e)  </span><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0">Standard</span><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0"> precautions;</span></p><p dir="ltr" class="sfe97768a-d468-464a-beb0-03f9567233a1P0"><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1000002"> </span></p><p dir="ltr" class="sfe97768a-d468-464a-beb0-03f9567233a1P0"><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0">    (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</span><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0">;</span></p><p dir="ltr" class="sfe97768a-d468-464a-beb0-03f9567233a1P0"><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1000002"> </span></p><p dir="ltr" class="sfe97768a-d468-464a-beb0-03f9567233a1P0"><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0">    (5)  </span><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0">The registered nurse must be available by electronic communication at all mealtimes; and</span></p><p dir="ltr" class="sfe97768a-d468-464a-beb0-03f9567233a1P0"><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1000002"> </span></p><p dir="ltr" class="sfe97768a-d468-464a-beb0-03f9567233a1P0"><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0">    (6)  </span><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0">The registered nurse shall complete an annual review of the nursing assistant s competence in each area identified in subdivision</span><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0"> (3).</span></p><p dir="ltr" class="sfe97768a-d468-464a-beb0-03f9567233a1P0"><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1000002"> </span></p><p dir="ltr" class="sfe97768a-d468-464a-beb0-03f9567233a1P0"><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0">    </span><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0-000001">Source:</span><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0"> 41 SDR 12, effective July 31, 2014</span><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0">; 49 SDR 51, effective November 27, 2022</span><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0">.</span></p><p dir="ltr" class="sfe97768a-d468-464a-beb0-03f9567233a1P0"><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0">    </span><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0-000001">General Authority:</span><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0"> SDCL </span><a href="https://sdlegislature.gov/Statutes?Statute=13-33A-2"><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0-000003">13-33A-2</span></a><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0">, </span><a href="https://sdlegislature.gov/Statutes?Statute=36-9-21"><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0-000003">36-9-21</span></a><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0">.</span></p><p dir="ltr" class="sfe97768a-d468-464a-beb0-03f9567233a1P0"><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0">    </span><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0-000001">Law Implemented:</span><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0"> SDCL </span><a href="https://sdlegislature.gov/Statutes?Statute=13-33A-1"><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0-000003">13-33A-1</span></a><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0">, </span><a href="https://sdlegislature.gov/Statutes?Statute=36-9-3"><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0-000003">36-9-3</span></a><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1C0">, </span><a href="https://sdlegislature.gov/Statutes?Statute=36-9-21"><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0-000003">36-9-21</span></a><span class="sfe97768a-d468-464a-beb0-03f9567233a1C0">.</span></p><p dir="ltr" class="sfe97768a-d468-464a-beb0-03f9567233a1P0"><span xml:space="preserve" class="sfe97768a-d468-464a-beb0-03f9567233a1000002"> </span></p></div></body></html>