PURPOSE: This rule sets forth the requirements for approval of an insulin administration training program, designates the required course curriculum content, outlines the qualifications required of students and instructors and outlines the testing and records requirements.

PUBLISHER’S NOTE: The publication of the full text of the material that the adopting agency has incorporated by reference in this rule would be unduly cumbersome or expensive. Therefore, the full text of that material will be made available to any interested person at both the Office of the Secretary of State and the office of the adopting agency, pursuant to section 536.031.4, RSMo. Such material will be provided at the cost established by state law.

1. (1) The purpose of the Insulin Administration Training Program shall be to prepare medication technicians in a skilled nursing (SNF) or intermediate care facility (ICF) or medication aides in a residential care facility (RCF) I or II to administer insulin. The program shall be designed to present information on diabetes as it relates to symptoms and implications of proper or improper treatment, and to teach skills in insulin administration in order to qualify students to perform this procedure in long-term care (LTC) facilities in Missouri.
2. (2) The course shall consist of at least four
3. (4) hours of classroom instruction by an approved instructor and shall include a final written and practicum examination. The practicum examination shall not be conducted in a simulated situation.
4. (3) The curriculum content shall include procedures and instruction in the following areas: diabetes and its treatment and complications, types of insulin, technique of insulin administration and methods of monitoring blood sugar levels.
5. (4) The manual entitled Insulin Administration (50-6080-S and 50-6080-I), 1990 produced by the Instructional Materials Laboratory, University of Missouri-Columbia, which is incorporated by reference in this rule, shall be the approved course curriculum. Students and instructors shall each have a copy of the manual.
6. (5) A student shall not administer insulin without the instructor present until s/he has successfully completed the course.

7. (6) Student Qualifications.

   1. (A) Any level I medication aide working in an RCF, who is recommended in writing for training by an administrator/manager or nurse with whom s/he has worked shall be eligible to enroll as a student in this course.
   2. (B) Any certified medication technician who is recommended in writing for training by the administrator or director of nursing with whom s/he has worked shall be eligible to enroll as a student in this course. The letter of recommendation shall be given to the training agency or instructor at enrollment.
8. (7) Instructor Qualifications. Only a registered nurse who is an approved instructor for the Level I Medication Aide Program, instructor/examiner for the Certified Nurse Assistant Program or instructor for the Certified Medication Technician Program shall be considered qualified to teach the Insulin Administration Course.

9. (8) Testing.

   1. (A) The final examination shall consist of a written and practicum examination administered by an approved instructor or examiner.

      1. 1. The written examination shall include

ten (10) questions extracted from the list in the instructor’s manual.

1. 2. The practicum examination shall

include the preparation, administration and recording of administration of insulin to a resident(s) under the direct supervision of the instructor/examiner.

1. (B) A score of eighty percent (80%) is required for passing the final written examination and one hundred percent (100%) accuracy in the performance of the steps of procedure in the practicum examination.
2. (C) The final examination, if not successfully passed, may be retaken one (1) time within thirty (30) days without repeating the course.

1. (9) Records.

   1. (A) The instructor shall complete the final record of the insulin administration course and shall distribute copies in the following manner:

      1. 1. A copy shall be provided to each indi-

vidual who successfully completes the course;

1. 2. A copy shall be kept in the instruc-

tor’s file; and

1. 3. The original shall be sent to a certi-

fying agency.

1. (B) Each student shall obtain a certificate from a state-approved certifying agency validating successful completion of the training program.
2. (C) Records shall be retained by instructors for at least two (2) years.

3. (D) The Division of Aging shall maintain a list of approved certifying agencies to handle issuance of certificates for the Insulin Administration Program. In order for an agency to be approved by the Division of Aging to be a certifying agency, it shall enter into an agreement of cooperation with the Division of Aging which shall be renewable annually and the agency shall effectively carry out the following responsibilities:

   1. 1. Review all documents submitted by

the instructor to assure that the instructor is qualified in accordance with section (7);

1. 2. Assure that all program requirements

have been met as set forth in these rules or as stipulated in the agreement with the Division of Aging;

1. 3. Issue certificates to individuals who

successfully complete the course;

1. 4. Provide the Division of Aging with

the names of those receiving certificates on at least a monthly basis; and

1. 5. Maintain accurate and complete

records for a period of at least two (2) years.

AUTHORITY: sections 198.009, RSMo Supp. 1997 and 198.073 and 198.076, RSMo 1994.* Original rule filed Oct. 15, 1990, effective March 14, 1991. Amended: Filed May 26, 1998, effective Nov. 30, 1998. *Original authority: 198.009, RSMo 1979, amended 1993, 1995; 198.073, RSMo 1979, amended 1984, 1992; and 198.076, RSMo 1979, amended 1984.