Insulin administration

[schooldistrictnurse]

What is the practice in your schools for insulin self-administration by middle and/or high school students ? The IHP from my local Children's hospital clearly states that students may do testing in the classroom but doesn't specify anything about insulin. I am in favor of allowing students to discreetly do their injections in the classroom as long as they keep their own sharps and don't disrupt.

I would call the diabetes clinic but I know they're swamped seeing their clients and getting updated IHP's out right now.

thanks

[BunnyBunnyBSNRN, ASN, BSN]

In my district, all DM stu's come into the nurse's office to do testing and insulin injections. I don't agree with stu's being able to test and self administer in the classroom, there is significant risk of "forgetting" or incorrect dosage that I am not willing to take a risk on.

[Jolie, BSN]

Our state law indicates that any student who wishes to self-carry and self-administer meds for asthma, anaphylaxis and/or diabetes must be allowed to do so.

This is within reason, of course. I meet with parents and students who wish to self-carry and self-administer before school starts and assess level of understanding, maturity, compliance, cooperation, need for monitoring, etc...... There are also legal releases that the parents and students must sign, which include the loss of self-medication privileges if abused.

In my Middle School last year, all of my diabetics self managed their insulin and blood sugars, mostly via pump. They were all good about coming to the office when they needed help. It was a pleasantly uneventful year.

At that age, most students don't like to call attention to themselves by going to the office. I truly think they would have been less compliant if they'd had to do so. Also, they are much more tech savvy than I am, and they taught me more about diabetes management than the other way around. They were all "experienced" diabetics. I would want a little "closer reign" on a newly diagnosed student.

[Neveranurseagain, RN]

When I get my written orders from the doctor on my DM students he includes this statement: "Blood sugar testing and insulin administration should take place in the classroom, if possible, to minimize disruption of the learning process and minimize the amount of time out of the classroom in accordance with IDEA." Next week, I will start checking a 3rd graders blood sugar in the classroom. Insulin will still be given in my office as he will be at recess after lunch so no need to give it in the classroom. I'm hoping it will eliminate the 45 min a day out of the classroom he currently has. But DM teaching will almost come to a standstill except at lunch.

[noreenl]

In NYC the MAF has a place to sign for the parent and the doctor to sign allowing a child to self test and slf administer. if consent is given a child can do these tasks ANYWHERE THEY CHOOSE. It involves a serious commitment on the part of the student and the nurse to communicate the need foir things like documentation and sharps issues and other care concerns, butr the student can test anywhere they feel the need and administer insulin as needed.