| Diabetic Management in Public schools | Grand Canyon University | | `` | 10/13/2013 |

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The following is a summary regarding a research study on the non-medical personnel assigned to care for Type I diabetic students in the state of Virginia public school system in the absence of a registered nurse following a legislative bill passed in the Senate in 1999.
The research conducted in 2005 and released in 2007 (Hellems & Clarke 2007) was implemented with questions regarding care of non-medical staff and whether that care provided was sufficient.

The research study was approved by the Virginia Intuitional review board with names of the children, the grade, and date of birth as the indicator for data collection purposes. There was no reference as to how this information was protected once collected. The qualitative data collected consisted of interviews with the parents on who was the actual caregiver of their child while in school, as well as whether their child participated in their own care.
The quantitative data collected included the above data on the children as well as the following; 185 participants attending 153 schools in Virginia utilizing cross referenced methods. The data included schools that contained a registered nurse, no nurse and non-medical staff assigned to diabetic management.
Further review of the study noted the children’s grades ranging from kindergarten to high school data reflecting overall equal amounts from each grade class; elementary 58 [31%], middle 60 [32%] and high school 67 [36%] (Hellems & Clarke 2007). The research also reflected a varied percent of assistance required by school staff with a higher percent in elementary school requiring assistance and decrease in the level of assistance with higher grades. Of the 185 participants noted in the study there were approximately 22% of parents spanning all grade levels who stated in the survey that they treated their child’s low blood glucose at school themselves
(Hellems & Clarke 2007). The non-medical staff indicated by the parents as being the assigned to treat their children ranged from teachers, gym coaches, administrative staff, cafeteria worker and bus drivers, of those 63% were trained by a registered nurse. Parents of 89% of the children did indicate a need for insulin administration during school hours with 79% injecting themselves (Hellems & Clarke 2007). In a study similar to the 2007 research conducted by( Hellems & Clarke, 2007) it was indicated that there was a concern whether the passed legislation would affect the use of trained nursing staff in the Virginia public schools and comparing the current data over the last 16 years there has actually been an increase from almost half of the districts lacking a nurse represented in the public schools in 1989.
The reader reviewed the state mandated guidelines created by the state board of nursing in Virginia (VBN, 2012) as outlined in guidance document 90-36. It states that all non-medical personnel be trained with no less than four hours of training in diabetic management and administration of insulin to a student in a Virginia public school only in the absence of a registered nurse. The non-medical staff will be trained by a licensed person such as a registered nurse or licensed physician in diabetic management and have that training updated annually with proper documentation on file for review. Although this was not part of the actual study it was referenced in the overall information provided in the research of the original legislative bill and the reader found this to be a question of importance regarding the training of non-medical staff caring for our children in a public setting. In addition to the training the original legislation also placed an amendment to protect such non-medical staff from liability for care provided under the Good Samaritan Act.

Conclusion The findings of the study indicate that it is both safe and practical alternative for non-medical personnel to care for type I diabetics during school hours (Hellems & Clarke 2007). Although the study did indicate some limitations to their findings regarding region of study, accurate recall by parents surveyed and adverse events. The addition of the Diabetes Association developing the Safe at School Statement of Principles (Diabetic Care 30) encourages all schools to identify individuals who will be responsible for the safe management of students with type I diabetes during school attendance. Preferably that would be a registered nurse, when that was not the case the Virginia legislation would be used as a model to implement the use of non-medical staff.

References

Hellems, M & Clarke, W (2007). Safe ar school: a Virginia experience. Diabetes Care, 30(6), 1396- 1398.

Senate Bill 889, Amending Virginia Code 8.01-225, 22.1-275.1, 54.1-3001, 54.1-3005, and 54.1-3408, 1999

American Diabetes Association: Diabetes care in the school and day care setting (Position Statement). Diabetes Care 30 (Suppl. 1 ): S66-S73, 2007