Delegation of Glucagon^® in the School Setting

Abstract

Delegation of nursing procedures and medication in school is fraught with legal and ethical concerns for the school nurse. Because nurses may be responsible for coordinating care for several school buildings, delegation of nursing care and medication administration has occurred out of necessity. Nurse Practice Acts in some states, but not all, allow for delegation of medication to unlicensed assistive personnel. This article explores Glucagon(®) delegation laws in the United States and presents an argument against such delegation in states where Nurse Practice Acts do not allow for delegation of medication to unlicensed assistive personnel.

The Role of School Nurses, Challenges, and Reactions to Delegation Legislation: A Qualitative Approach

“…These five rights include the right task, under the right circumstances, to the right person, with the right directions and communication, and under the right supervision and evaluation (Mueller & Vogelsmeier, 2013). However, many states have passed laws and regulations regarding delegation that vary considerably, and sometimes policies within states contradict one another (Wilt & Foley, 2011). New legislation often demands changes in other policies and regulations, so that all are compatible.…”

Accuracy in Publishing

“…I would like to acknowledge Lori Wilt and Marie Foley for providing a valuable literature review and discussion around the issue of delegating Glucagon in the school setting (Wilt & Foley, 2011).…”

“…The discussion section describes a position against delegation of Glucagon including “a nursing assessment is a required element in this circumstance.” (Wilt & Foley, 2011, p. 192) An important tool related to the administration of Glucagon, an emergency care plan (ECP), is not described in this article. The use of an ECP developed by the school nurse is essential for managing hypoglycemia (NASN, 2006).…”

“…Wilt and Foley (2011) report that “The American Diabetes Association (ADA) recommends glucagon or glucose gel for unconsciousness” (p. 194). I am concerned about the lack of evidence that this quote is based on.…”

“…A manuscript published in the June 2011 issue of The Journal of School Nursing provides a perfect example of the complex steps required to assure accuracy in policy and health services delivery scholarship. Wilt and Foley (2011) published a review of regulations regarding delegation of care concerning Glucagon administration in 50 states. Their approach was to review regulations in the literature and on Internet sites then summarize the report, showing the differences across states.…”