Overview of medication issues and administration of medications in school

Adebola E. Orimadegun

Healthy children Learn Better

Important to know that:“children bring their whole life to school with them……and it doesn’t fit in a locker.”

Many children require medications while at school, so that they can be active participants in the classroom

What does National Drug Policy says?

No definitive policy on medication issues in school.

Lessons for other policies:Only non-injectable medications are allowed outside standard clinic and hospital settings

It is recommended that with the exception of an emergency situation, a licensed professional nurse administer injectable medication.

What does National Drug Policy says?

Only trained staff can administer medication

Designated school personnel are REQUIRED to receive appropriate training approved for the administration of prescription and non prescription medication.

Three Med Classifications

Non-prescription medication

Pupils/Student self-administered medications

Prescription medications

Non-prescription Medications

You must have Written Instructions from the pupil’s Parent/Guardian in order to give non-prescription medications

Non-prescription Medication

Must have a signed parent/guardian permission form which includes:

Pupil’s nameMedicationMedication dosage, frequency, and route

Must be in the ORIGINAL CONTAINER

Non-prescription Medications

May only be allowed if:The medication is necessary for the child to remain in school

Excludes:Dietary Supplements Food Supplements

Must be:Commercially prepared and non-alcohol

Pupil Self Administration

For now no policy and procedures that govern self administration of medications in school

In ORDER FOR A CHILD TO DO SO:Documented approvals are needed:

Parent/GuardianSchool AdministratorStudentDoctor (if prescription)

Self Administration

Requires no assistanceRequires no documentation that the medication was takenEach school develops own policy to address self medication

Prescription Medications

ONLY CERTAIN PEOPLE CAN WRITE a PRESCRIPTION:

Doctor of MedicineNurse PractitionerDentistOptometrist

Prescription Medications….

Must be prepared and labeled by a pharmacistOnly administer if required during school hoursMust have a signed permission and instruction from parentSeparate training is needed for any injectable medications

A Little More on Prescriptions

Written Instruction from a physician (prescription label will meet this requirement)Original Pharmacy containerVerbal doctors orders can only be taken by a licensed nurse

Giving Medications in school: the Five Rights

Right StudentRight MedicationRight DoseRight TimeRight Route

Handling Medications

Get water from a clean sourceAlways wash your hands!Avoid Touching the medicationsWear gloves if placing medication in the pupil’s mouth

Handling Medications

If tablets require cutting, it is good the parent needs to cut them at home prior to sending them to schoolCalibrated spoon/cup for liquid medications

Scheduling and timing of medications

Stress the importance of reading and following the label instructions.

Medication should be given within 30 minutes either side of the prescribed time.

Routes of Medications-Oral-

MouthTabletsCapsulesSyrups, elixirs and suspensions

Route of MedicationTopical

Topical (on the outside of the body)

SkinEyesEarsNose

Routes of MedicationInhaled

InhalationNoseMouth

Safe Storage and Handling

Store all medication in the original ContainerStore in a clean, locked cabinet

File CabinetLock boxSafe

Safe Handling……

Changes in medication instructions should always be made in writing from the parent/guardianDo not act on Verbal requestsRefrigeration may be needed for some medications

Disposing of Medications

Follow policy for disposal of unused or expired medications:

Use the sink or toiletRegulated waste

Pupil’s Medication Record

One sheet to sign in the supply and sign outOne sheet to show what was administered by whom and when

Confidentiality

Pupil’s medication files are confidential Only parent/guardian and authorized school staff should have accessParent/guardian authorization is required for release of information

Handling the Unexpected

Student does not come at scheduled Med Time

Send for themDocument on the medication recordNotify the parents via phone and in writing (forms are on the internet)

Pupil Refuses Medication

Encourage the child to take the medicationDocument on the medication recordNotify the parent/guardian in writing

Pupil Vomits or Spits Out Medication

DocumentNotifyCheck for symptoms of illness

Take temperature

Medication Errors

Report the medication error immediately

Parent/guardianPhysicianNurseBuilding administrator

What Are Medications Errors

Dose OmittedMedication given to wrong studentInaccurate dose or wrong medicationWrong timeIncorrect route

Side Effects

All medications have a potential for side effectsIf in doubt check medication fact sheets, call the pharmacy, or contact the school nurse

Antibiotics-may cause a rashAnalgesics-may cause an upset stomach

Side Effects

Report promptly any unusual

Symptoms Behaviors

To the school nurse and parent

Dealing with Concerned Parents

Validate parents concerns and emotions by listening and identifying a way to address their specific concern

Share written information

Include school nurse/administrator

Set boundaries and ensure your own safety

Cooperative School Environment

Success requires

TEAM EFFORT

Cooperative School Environment

Include the teacher in plans, send them a notice so that they are aware that medications are being administeredShare information on medication times at the staff meetingsTalk with school staff to help problem solve missed medication times

Thoughts

School staff are protected by law if careful observation of the regulations are observedAny Questions

Thank you