Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 11 - TEXAS BOARD OF NURSING › Chapter 225 - RN DELEGATION TO UNLICENSED PERSONNEL AND TASKS NOT REQUIRING DELEGATION IN INDEPENDENT LIVING ENVIRONMENTS FOR CLIENTS WITH STABLE AND PREDICTABLE CONDITIONS › Section 225.12 - Delegation of Insulin or Other Injectable Medications Prescribed in the Treatment of Diabetes Mellitus

Current through Reg. 49, No. 28; July 12, 2024
In addition to all previous criteria listed, when delegating
				  administration of insulin or other injectable medications prescribed in the
				  treatment of diabetes mellitus administered subcutaneously, nasally, or via
				  insulin pump the RN must:
(1) arrange
				for a RN to be available on call for consultation/intervention 24 hours each
				day;
(2) provide teaching of all
				aspects of insulin or other injectable medications prescribed in the treatment
				of diabetes mellitus administered subcutaneously, nasally, or via insulin pump
				to the client and the unlicensed person to include, but not limited to proper
				technique for determination of the client's blood sugar prior to each
				administration of insulin or other medication, proper injection technique,
				risks, side effects and the correct response(s). The RN must leave written
				instructions for the performance of administering insulin or other injectable
				medications prescribed in the treatment of diabetes mellitus subcutaneously,
				nasally, or via insulin pump, including a copy of the physician's order or
				instructions, for the unlicensed person, client, or client's responsible adult
				to use as a reference;
(3) delegate
				the administration of insulin or other injectable medication prescribed in the
				treatment of diabetes mellitus subcutaneously, nasally, or via insulin pump to
				an unlicensed person, specific to one client. The RN must teach that the
				administration of insulin or other injectable medication prescribed in the
				treatment of diabetes mellitus subcutaneously, nasally, or via insulin pump is
				to be performed only for the patient for whom the instructions are provided and
				instruct the unlicensed person that the task is client specific and not
				transferable to other clients or providers;
(4) delegate the administration of insulin or
				other injectable medication prescribed in the treatment of diabetes mellitus
				subcutaneously, nasally, or via insulin pump to additional unlicensed persons
				providing care to the specific client provided the registered nurse limits the
				number of unlicensed persons to the number who will remain proficient in
				performing the task and can be safely supervised by the registered
				nurse;
(5) make supervisory visits
				to the client's location at least 3 times within the first 60 days (one within
				the first two weeks, one within the second two weeks and one in the last 30
				days) to evaluate the proper medication administration of insulin by the
				unlicensed person(s). After the initial 60 days, the RN, in consultation with
				the client or client's responsible adult, shall determine the frequency for
				supervisory visits to assure the proper and safe administration of insulin by
				the unlicensed person(s). Separate visits shall be made for each unlicensed
				person administering insulin;
(6)
				make supervisory visits in the event there are changes in the client's status;
				and
(7) ensure that the client or
				client's responsible adult acknowledges in writing that the administration of
				medication(s) under this section will be delegated to an unlicensed
				person.