Injections

[Gems0607]

How do you guys handle cortisol injections? Are health techs or trained staff in the school able to draw up and give the injection in an emergency for the child? If not what is the rationale or reason this is different from an Epi-pen injection. We have a child who will need this in the event of an emergency, I work in a childcare facility and we have 7 centers and only myself and another nurse. The staff aren't comfortable and I can't find anything that says which way we should go.

[Farawyn]

I would call your state. That's how I found out the parameters about Diastat.

[Flare, ASN, BSN]

I had a student with this a few years ago. As far as i understood, this is a task i can't delegate in my state. I never had to give it to my student. It sat idly in my cabinet until the student transferred out.

[JenTheSchoolRN, BSN, RN]

I can't delegate glugacon unless a staff member is specifically trained. Only injection I can delegate is an Epipen in my state.

[Gems0607]

Thank you all for your reply. I spoke with one of our local school nurses and she stated that only a LMP could do it as well. Do you guys know the difference or why it's different from diastat or Epi? My coworker is trying to wrap her head around why can they be trainer for those but not cortisol.

[KKEGS, MSN, RN]

Diastat and EpiPens are ready to use whereas medications like glucagon and cortisol have to be prepared using a multi step process. Because it's more complicated perhaps that is the reason it is left to the licensed pros?

[ruby_jane, BSN, RN]

Diastat and EpiPens are ready to use whereas medications like glucagon and cortisol have to be prepared using a multi step process. Because it's more complicated perhaps that is the reason it is left to the licensed pros?

You're right, but the answer is also does the state allow (via delegation or legislation) us to pass that off? Epi Pen - yes, we train teachers to do this. Glucagon - in Texas we can delegate but it's complicated. Diastat - we have a policy that we can delegate; the BON is fuzzy on this but does allow me to say no, I don't feel this is delegable.

[KKEGS, MSN, RN]

You're right, but the answer is also does the state allow (via delegation or legislation) us to pass that off? Epi Pen - yes, we train teachers to do this. Glucagon - in Texas we can delegate but it's complicated. Diastat - we have a policy that we can delegate; the BON is fuzzy on this but does allow me to say no, I don't feel this is delegable.

I wish we had more clear cut guidelines but we don't. Our legislation is very vague so we have to decide district by district. And even with that, our only true policy (passed by the school board) is authorization to give medications at school but it doesn't specify which types/routes can be given by whom.

[ruby_jane, BSN, RN]

I wish we had more clear cut guidelines but we don't.

AMEN.

Go back to the BON each and every time because I guarantee you there's probably a line in there that cautions you against doing something (or delegating something) you feel you're not competent to do.

[NutmeggeRN, BSN]

It really depends on who write the original legislation or rules...there are variances in rules within our state.

[Flare, ASN, BSN]

My student with this order just re-registered today. So it looks like i'll have this order active again. i'll let you know if anything changed as far as orders from then vs now, but i still can't delegate it in my state. Actually mom was a bit eh when i asked if she was going to get me an order again so i'm not totally expecting that i'll actually get an order.