Arkansas Administrative Code › Agency 005 - DEPARTMENT OF EDUCATION › Division 28 - Division of Elementary and Secondary Education › Rule 005.28.22-005 - Rules Governing the Administration of Insulin, Glucagon, and Medication for Adrenal Insufficiency or Adrenal Crisis to Arkansas Public School Students

Current through Register Vol. 49, No. 6, June, 2024
ARKANSAS DIVISION OF ELEMENTARY AND SECONDARY EDUCATION
				AND STATE BOARD OF NURSING RULES GOVERNING THE ADMINISTRATION OF INSULIN,
				GLUCAGON, AND MEDICATION FOR ADRENAL INSUFFICIENCY OR ADRENAL CRISIS TO
				ARKANSAS PUBLIC SCHOOL STUDENTS
Effective May 3, 2022
CHAPTER 1:
REGULATORY AUTHORITY, PURPOSE, AND
				DEFINITIONS
1.00
REGULATORY AUTHORITY
These rules are enacted pursuant to the Arkansas State Board of
				Education's authority and the Arkansas State Board of Nursing's authority under
				Ark. Code Ann. §§
										6-11-105,
				6-18-711,
				6-18-718,
				17-87-103,
				and
				17-87-203.
2.00
PURPOSE
The purpose of these rules is to set forth protocols and
				procedures for the administration of insulin, glucagon, and medication for
				adrenal insufficiency or adrenal crises by a student or trained volunteer
				school personnel.
3.00
DEFINITIONS
3.01 "Adrenal crisis"
			 means a sudden, severe worsening of symptoms associated with adrenal
			 insufficiency, which can lead to circulatory collapse, heart and organ failure,
			 brain damage, and death.
3.02
			 "Adrenal insufficiency" means:
3.02.1 A
			 chronic medical condition in which the adrenal glands do not produce enough of
			 the necessary hormones to respond to stressors such as illness and injury;
			 and
3.02.2 The hormones involved
			 help maintain and regulate key functions of the body such as blood pressure,
			 metabolism, the immune system, and how the body responds to stress.
3.03 "Diabetes" means a group of
			 metabolic disorders characterized by hyperglycemia resulting from defects in
			 insulin secretion, insulin action, or both.
3.04 "Emergency dose medication" (for
			 purposes of adrenal crisis) means intramuscular hydrocortisone sodium
			 succinate.
3.05 "Emergency
			 Situation" means a circumstance in which students with low blood glucose cannot
			 be treated with a glucose-containing substance by mouth because the student has
			 an altered mental state, is having a seizure, or has high blood glucose
			 requiring emergency administration of insulin to prevent
			 complications.
3.06 "Glucagon"
			 means a hormone prescribed by a licensed healthcare practitioner that
			 stimulates the release of glucose in the blood. Glucagon is dispensed as a
			 "Glucagon Emergency Kit" or a "Glucagon Emergency Kit for Low Blood
			 Sugar."
3.07 "Insulin" means a
			 hormone that regulates the metabolism of glucose and other nutrients. It
			 generally is given by injection or through a subcutaneous insulin delivery
			 system. It is prescribed by a licensed healthcare practitioner.
3.08 "Licensed Healthcare Practitioner"
			 includes, but is not limited to, Medical Doctors, Doctors of Osteopathy,
			 Advanced Practice Registered Nurses with prescriptive authority, Registered
			 Nurse Practitioners, and Physician Assistants who work under physician-approved
			 protocols.
3.09 "Licensed School
			 Nurse Employed by a School District" means those nurses employed by an Arkansas
			 public school district or open-enrollment public charter school who hold the
			 following licenses or certificate:
3.09.1
			 Registered Nurse (RN);
3.09.2
			 Advanced Practice Registered Nurse (APRN); or
3.09.3 Diabetes Nurse Educator.
3.09.4 This definition does not include
			 License Practical Nurses (LPNs). LPNs may assist in the provision of training
			 under these rules. However, training under these rules must be performed by
			 Registered Nurses, Advance Practice Registered Nurses, or Diabetes Nurse
			 Educators.
3.10
			 "Non-scheduled dose of insulin" means an additional or corrective dose of
			 insulin to treat hyperglycemia or to cover a rise in blood glucose
			 levels.
3.11 "Other Healthcare
			 Professional" includes the following:
3.11.1
			 Registered Nurse (RN);
3.11.2
			 Advanced Practice Registered Nurse (APRN);
3.11.3 Diabetes Nurse Educator;
3.11.4 Medical Doctor (MD);
3.11.5 Registered Nurse
			 Practitioner;
3.11.6 Doctor of
			 Osteopathy;
3.11.7 Physician
			 Assistant;
3.11.8 Pharmacist;
			 and
3.11.9 Certified Diabetes
			 Educator.
3.12
			 "Scheduled dose of insulin" means a dose of insulin administered at regular
			 times during the school day.
3.13
			 "Stress dose medication" (for purposes of adrenal insufficiency) means oral
			 hydrocortisone.
3.14 "Trained
			 Volunteer School Personnel" means licensed or classified personnel employed by
			 an Arkansas public school district or open-enrollment public charter school who
			 volunteer and successfully complete training for the administration:
3.14.1 Of insulin, glucagon, or both to
			 students diagnosed with diabetes; and
3.14.2 Of an emergency dose medication to a
			 public school student who is diagnosed with an adrenal insufficiency using the
			 appropriate delivery equipment when a public school nurse is
			 unavailable.