Medication administration *a guide for training unlicensed school staff
Created by:Health Services
October, 2016Administration of Medication*recertification for school employees
1North Dakota Department of Health: Community Health Section
Participants will have an understanding of federal and local laws regarding medication administration in schools. Participants will be able to verbalize the seven rights of medication administration.Participants will know best practices of storing, handling and disposing of medications in the school setting.Participants will understand proper documentation content and procedures needed to safely administer medications in school.Participants will be able to recognize and respond appropriately to the enumerated medical conditions commonly encountered in District of Columbia Schools.Participants will successfully complete a hands-on return demonstration of medication administration.
The purpose of this presentation is to provide a guideline to aide in training non-licensed school personnel in medication administration.
Students safety when administering medications is always the MAIN priority.purpose
Medication Administration Training ProgramThe Mayor of DC has developed and implemented a medication administration program, which shall provide training and certification of employees and agents of a school to:Administer medication to students with valid medication action plans who are not authorized to possess that medication or are not competent to self-administer the medication; andAdminister medication in emergency circumstances to any student suffering an acute episode of asthma, anaphylaxis, or other illnessAll training provided pursuant to subsection (a) of this section shall be conducted by a health care professional licensed in the District of ColumbiaA health care professional shall provide a school with written certification of successful completion of the training for each employee or agent of the school. The certification shall be valid for 3 years.Code of the District of Columbia
Code of the District of Columbia 38-651.05 Administration of Medication reads as follows:An employee trained and certified pursuant 38-651.04 may administer medication to a student with a valid medication action plan; provided, that:The responsible person has delivered the medication to be administered to the school;The employee or agent of the school is under the general supervision of licensed health practitioner; and Except in emergency circumstance, the responsible person has administered the initial dose of a new medication.
Code of the District of Columbia
A student may possess and self-administer medication at the school in which the student is currently enrolled, at school-sponsored activities, and while on school-sponsored transportation, in order to treat asthma, anaphylaxis, or other illness; provided that:The responsible person has submitted a valid medication action plan to the school.
Student self-carry legislation
School Administrators are responsible for designating someone within the school to be trained in medication administration.Education and training must be completed by the designated staff member.Details regarding this training:Who trains?The School NurseWhat is the training?The Administration of Medication Training provided by the DC DOH and Childrens School ServicesHow often is the training required?Every 3 years
What does this mean?
If a medication can be given at home and not brought into the school at all, this is ideal.For example: medications prescribed to be taken three times a day (TID) could be given at home before school, after school, and in late evening/bedtime. Discuss with parents these options before making the decision to store and administer a medication in school.
Home before school if possible!(We know this isnt always possible.)
First things first
Prescription (ordered by a health care providerphysician, dentist, nurse practitioner, physician assistant)ADHD meds: most are a controlled substance (oral, transdermal patch)Antibiotics (oral, ear drops, eye drops)Anti-seizure meds (oral, rectal-Diastat)Diabetic meds: (insulin, Glucagon (injections)Asthma meds: (inhaled, oral)EpiPen (injection)OthersOTC (over the counter) medicationsAcetaminophen (Tylenol)Ibuprofen (Advil, Motrin, etc.)Cetirizine (Zyrtec)Diphenhydramine (Benadryl)OthersSidwell Friends School has a written policy on medication administration. Be familiar with this policy, Medications in schoolAll prescription and OTC meds need a health care providers order!
Medications must be brought in by parents/guardians. First, determine Option 1: Is this a medication that is to be stored in a locked cabinet (health services office if on campus) that staff need to help administerOption 2: Is this a medication that the student carries and self-administers?Inhalerasthmatic reactionsEpinephrinesevere allergic reactionsOthers?Many times, providers will write a note stating that a child should have their rescue inhaler or Epipen with them. This should also be a part of the medical care plan for that student.Bringing meds into school Self-carry meds are generally those that are used in life-threatening situations and the student needs immediate access to them!
Next, make sure proper paperwork is completed. Medication Authorization Form Name of medication (as it appears on the medication bottle/container) and strengthDoseRouteWhen to giveWhat the medication is to be given forParents signatureSpecial instructionsi.e. please call parent before administering medication.Written order (signed) from prescribing provider This can be a separate form but should be with or attached to the medication form. For all prescription medicationsFor OTC medications (OTC Medication Authorization Form)especially if off-label or different dose than recommendedPaperwork
Paperwork valid for current school year only.
Self Carry/Self AdministerSection is included on the Medication Authorization Form and must be: Signed by parentSigned by the licensed healthcare providerMedication Administration Flow SheetEach medication should have its own row on the form. See example (next slide)All paperwork must match medication label. If the paperwork does not match, you will need to redo it and get the appropriate signatures again.Any changes in dose or medication require a new written provider order. Paperwork, cont.
Notice codes!This is an example
How to read aprescription (rx) label
Medication must be in the original container whether its prescribed or OTC.No medications in Ziploc bags, spice bottles or other containers.Why? You need to be sure the medication is really what they say it is. You need to know the lot number, expiration date and strength.You should document the quantity brought in.Count and document the quantity of the medication or if its an unopened bottle of pills, take note of the quantity in the bottle. For liquids, you can document how many mLs are present when brought in.Controlled substances: should be counted, logged (both in and out), and recounted at least weekly to make sure there is no drug diversion. Drug Diversion is when licit drugs are used for illicit purposes. Basically, the medication is being used in an illegal manner. It is not uncommon for people to steal medications, especially controlled substances. You need to keep tight control of these types of medications! Medication storage
Controlled SubstanceDefinition: a substance subject to the U.S. Controlled Substances Act (1970), which regulates the prescribing and dispensing, as well as the manufacturing, storage, sale or distribution of substances assigned to five schedules according to their 1) potential for or evidence of abuse, 2) potential for psychic or physiologic dependence, 3) contribution to a public health risk, 4) harmful pharmacologic effect, or 5) role as a precursor of other controlled substances.http://www.drugs.com/dict/controlled-substance.html
What is a controlled substance?
Adderall 30 mgAdderall XR 30 mgRitalin 10 mg
Controlled substances in schools
Ritalin 20 mg
Focalin 10 mg
Focalin 5 mg
Focalin XR 10 mgFocalin XR 20 mg
Intuniv 2 mgIntuniv 3 mgAll medication pictures from www.drugs.com
Controlled substances in schools
Vyvanse 50 mgVyvanse 30 mg
Metadate CD 20 mgMetadate CD 30 mg
Metadate ER 20 mgCD=controlled deliveryCR=controlled releaseER=extended releaseLA=long actingSR=sustained releaseTR=time releaseXR=extended releaseXL=extended releasehttps://www.riverpharmacy.ca/faq/what-do-the-acryonyms-cd-cr-la-sr-tr-xl-and-xr-stand-for
All medication pictures from www.drugs.com
Locked cabinetLocked office/room OrganizedMany different ways to do this.what works best for you?AlphabeticalTime of day meds are to be givenThe better things are organized, the less chance for mistakes!CleanAway from light/sunOral medications separated from topical medicationsRefrigerators:Medications in fridgesinsulin, certain antibioticsDesignated medication fridge (no personal food/drinks)Generally temps between 36-46 Fahrenheit. Colder or warmer temps can change medications effectiveness.
double locking is best practice
All medications (both prescription and OTC) should have the students name and date of birth on them. You will need to hand write this on the bottle of OTC medications.
Medication storage cont.
SHOULD BE:Organized, clean and easy to read*label with students nameMessy, mixed together
Medications are serious businesseven OTC ones. Before giving any med