Scope of Practice

New Directive on Training Unlicensed Personnel in Glucagon Administration

A decision was recently rendered by the New York State Education Department (SED) and the Department of Health (DOH) that permits licensed registered nurses in the school setting to train unlicensed individuals in the administration of glucagon for emergency situations.

Customarily, teaching or delegating the protected scope of practice to an unlicensed person is viewed as unprofessional conduct, subjecting the nurse to possible charges by the Office of Professional Discipline. The State Education Department determined that when a registered nurse trains an unlicensed individual to administer glucagon in anticipation of a diabetic emergency, in which a nurse is not available, as prescribed by an authorized provider, the act of providing such training does not constitute professional misconduct on the part of the licensed nurse.

The training must adhere to the following requirements:

In the school setting, the parent/guardian of the student(s) with diabetes should provide the school with the prescriber’s written order, supplies to treat hypoglycemia, including a source of glucose and a glucagon emergency kit.

The emergency glucagon kit contains 1 mg of freeze-dried glucagon in a vial and 1 ml of water for reconstitution in a syringe. It is to be used, if authorized for that student, when the student exhibits unconsciousness, unresponsiveness, convulsions or seizures or has the inability to safely eat or drink. After administration of the prescribed amount, any remaining medication should be discarded appropriately. This does not eliminate the necessity to activate the emergency medical system or call 911.

This agreement follows the American Diabetes Association’s claim that administration of glucagon to a student with diabetes who is not experiencing hypoglycemia will not harm the individual.

Glucagon administration training guidance is available for download online.

For questions, contact Education, Practice and Research: 800.724.NYRN, ext. 282