Section 1265.6 Of Article 2. Administration From California Health And Safety Code >> Division 2. >> Chapter 2. >> Article 2.
1265.6
. Notwithstanding any other provision of law, a registered
nurse within his or her scope of practice may require direct care
staff in an intermediate care facility/developmentally disabled
habilitative or an intermediate care facility/developmentally
disabled-nursing to administer blood glucose testing for a person
with developmental disabilities who resides at the facility and who
has diabetes, if all of the following criteria are met:
(a) The blood glucose testing is specifically ordered by a
physician. The results of the testing shall be reported to a
registered nurse as specified in the physician's order.
(b) Prior to performing the blood glucose testing, the direct care
staff shall be trained by the registered nurse to perform the
testing and shall demonstrate proficiency in performing the testing
while under the immediate supervision of the registered nurse.
(c) Training of direct care staff to perform blood glucose testing
shall include, but not be limited to, an overview of the basic
disease process of type I and type II diabetes, recognition of the
signs and symptoms of hypoglycemia and hyperglycemia, the role of
nutrition management in diabetes, diabetes and blood sugar control,
long-term complications of diabetes, specific instruction in
utilizing and the use of a specific over-the-counter glucose
monitoring device that is approved by the FDA, including the cleaning
and maintaining the accuracy of the client-specific glucose
monitoring device, proper infection control practices related to the
use of the device, including the handling and disposal of infectious
waste, and recording accurate records of blood glucose readings in
the client medical record. Records of blood glucose readings shall be
reviewed by the facility registered nurse at least monthly.
(d) A signed written statement shall be prepared by the registered
nurse that includes a certification of the direct care staff's
competence to perform the testing and that identifies the clients
residing at the facility for whom the certification is applicable.
This certification shall be placed and maintained in the direct care
staff's training record.
(e) The certification of competence to perform the blood glucose
testing shall be procedure and client specific, and shall not be
transferred between clients residing at the facility or other
facilities.
(f) The registered nurse shall be responsible for monitoring and
implementing the direct care staff blood glucose testing. At least
once every three months, the registered nurse shall observe and
confirm the direct care staff person's proficiency in performing the
approved testing and shall update the certification. The proficiency
determination shall include a determination by the registered nurse
that the direct care staff remains proficient in demonstrating the
specified method for cleaning and recalibration of the glucose
monitoring device.
(g) A registered nurse shall provide continuing in-service
education on the management of diabetes and the use of blood glucose
monitoring devices not less than once per year and include
documentation of the content of the training and the staff who were
in attendance.
(h) A facility shall develop a written policy and procedure
governing blood glucose testing for clients residing at the facility
that shall include procedures for the training and competency
assessment of direct care staff as required by this section.
(i) A facility shall have received a certificate of waiver
pursuant to subdivision (n) of Section 483.460 of Title 42 of the
Code of Federal Regulations prior to the implementation of blood
glucose testing and shall retain a copy of the CLIA waiver for
inspection by the department.