AGING AND DISABILITY SERVICES ADMINISTRATION
August 27, 2001
AASA: BH #2001-016
SUBJECT: Use of Insulin Pens in BH
Dear Boarding Home Provider:
This letter provides information about insulin pens and their use in Boarding Homes.? Insulin pens provide a means of delivering the appropriate dose of insulin to the patient.? The pen has a cartridge that holds the insulin, a cartridge holder that has a mechanism to dial the correct dose, and a needle that must be placed in the device when it is time for injection.?
Boarding Home providers and licensors have asked questions about what is acceptable practice for caregivers related to assisting residents with these insulin pens.? At their January 17,, 2001 meeting, the Board of Pharmacy was asked by a Tacoma pharmacist for an interpretation of the Medication Assistance rules and insulin pens.? The Board of Pharmacy stated that Medication Assistance rules specifically exclude injectable medications (WAC 246-888-020).? Therefore, the Board concluded that assisting with insulin pens is considered medication administration.? Caregivers not legally authorized to administer medications must not assist the resident to dial the insulin dosage, change the needle, or similar actions.? The Nursing Care Quality Assurance Commission also considers that ?dial-a-dose? insulin pens are injectables and therefore, assisting the resident with their use is not a delegatable task under Nurse Delegation (RCW 18.79.260(3)(d)(ii).? ??
If you have questions, please contact your Field Manager.
Sincerely,
Patricia K. Lashway, Director
Residential Care Services
Enclosures
cc:??RCS Regional Administrators
? RCS Field Managers
Nancy Tyson, BH Enforcement Officer

