19 CSR 30-84.040 Insulin Administration Training Program


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 secretary of state has determined that the publication of the entire text of the material which is incorporated by reference as a portion of this rule would be unduly cumbersome or expensive. This material as incorporated by reference in this rule shall be maintained by the agency at its headquarters and shall be made available to the public for inspection and copying at no more than the actual cost of reproduction. This note applies only to the reference material. The entire text of the rule is printed here.


  • The Insulin Administration Training Program shall be administered by the Department of Health and Senior Services (the department) in order to prepare medication technicians in a skilled nursing facility (SNF) or intermediate care facility (ICF), or medication aides in a residential care facility (RCF) or an assisted living facility (ALF) 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. All aspects of the Insulin Administration Training course included in this rule shall be met in order for the program to be


  • The course shall consist of at least four (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.


  • 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.
  • The manual entitled Insulin Administration (50-6080-S and 50-6080-I), 2001 edition, produced by the Instructional Materials Laboratory, University of Missouri-Columbia, which is incorporated by reference in this rule, and available through the Department of Health and Senior Services, PO Box 570, Jefferson City, MO 65102-0570, shall be considered the approved course curriculum. This rule does not incorporate any subsequent amendments or additions to the materials incorporated by reference. Students and instructors shall each have a copy of the manual.


  • A student shall not administer insulin without the instructor present until s/he has successfully completed the course.


  • Student
    • Any level I medication aide working in an RCF or ALF, 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
    • 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


  • 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


    • The final examination shall consist of a written and practicum examination administered by an approved instructor or
      1. The written examination shall include ten (10) questions extracted from the list in the instructor’s
      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.
    • 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
    • The final examination, if not successfully passed, may be retaken one (1) time within thirty (30) days without repeating the


    • The instructor shall complete the final record of the insulin administration course and shall distribute copies in the following manner:
      1. A copy shall be provided to each individual who successfully completes the course;
      2. A copy shall be kept in the instructor’s file; and
      3. The original shall be sent to a certifying
  • Each student shall obtain a certificate from a state- approved certifying agency validating successful completion of the training
  • Records shall be retained by instructors for at least two (2) years.
  • The department 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 department to be a certifying agency, it shall enter into an agreement of cooperation with the department which shall be renewable annually and the agency shall effectively carry out the following responsibilities:
  1. Review all documents submitted by the instructor to assure that the instructor is qualified in accordance with section (7);
  2. Assure that all program requirements have been met as set forth in these rules or as stipulated in the agreement with the department;
  3. Issue certificates to individuals who successfully complete the course;
  4. Provide the department with the names of those receiving certificates on at least a monthly basis; and
  5. Maintain accurate and complete records for a period of at least two (2)