I
n South Dakota (SD) in 2008, legislative efforts were moving forward
to pass a bill allowing unlicensed assistive personnel (UAP)
to administer insulin and provide other diabetes care in the school
setting without nursing oversight. This legislation was prompted by
increasing numbers of children with insulin-dependent diabetes and
concerns from parents regarding less-than-adequate care of children
in schools where nurses were not present (Damgaard & Young, 2014).
The proposed legislation was supported by SD’s Diabetes Educators
Association but opposed by SD’s School Nurses Association, which
expressed concerns regarding the safety of having UAP administer
insulin. In response to the proposed legislation and the concerns,
the SD Board of Nursing (BON) conducted a pilot study to examine
the safety and efficacy of nurses delegating insulin administration to
trained UAP in school settings.
The pilot study, “Virtual Nursing Care for Children with
Diabetes in the School Setting,” was conducted from December 1,
2010, through May 31,2013 (Damgaard & Young, 2014). The study
linked trained UAP in school settings with registered nurses (RNs)
by means of technology. The technology allowed nurses to virtually
delegate and supervise diabetes care tasks, including insulin administration,
to trained UAP. Findings from the study supported the use
of the virtual nurse model of care as a safe and effective method to
supervise and delegate diabetes nursing care tasks to UAP, including
insulin administration. This article provides an update on the progress
of this project, policy changes, and req