Medication Administration

Medication Administration A Training for School Personnel January 2008 Begin

Welcome to LCSD annual medication administration re-training. This program contains information required by law to administer medications to school students. In order to complete this training, you must have previously attended a course presented by the district nurse.Please read all of the information and complete the quiz. Following the quiz, there is a page to submit me an email. I will send you a a course evaluation. This information will help me to improve this course. Make sure your name, job description, and building is filled out This information is required for our records.If this is your first time completing this course, allow 1/2 hour to do so. NextBack

Goal This training is intended for non-nurse school staff who have been assigned to give medications in school, following the legal guidelines of ORS 339.867 to 339.870 NextBack

What the Law Says • Administrator must select regular and back up staff • Designated school personnel are REQUIRED to receive training annually • ONLY trained staff can administer medication • Training program must be approved by Oregon Department of Education Next Back

The Law • Administrative rules were adopted by the Oregon Department of Education in 1997, and amended by the legislature in 2004 • School districts must adopt policies and procedures for this rule including policies which address student self medication. Next Back

Note: • Only non-injectable medications are covered by this law • Nebulizer treatments, injections and rectal medication administration will not be taught in this training Next Back

Three Types • Prescription medication • Non-prescription medication • Student self-administered medications Next Back

Prescription Medications Requires school personnel to be responsible only for prescription medication scheduled to be given during school hours, or non-prescription medications necessary for the child to remain in school. Next Back

Prescription Medication • Does not include injectable drugs • Must be prepared and labeled by pharmacists and be in the original pharmacy container Next Back

Prescription Medication • Requires written instruction from a physician (prescription label meets this requirement) • Requires signed permission and instruction from parent (medication permission form HE-26) • New medication permission form must be completed each year • Administered only if required during school hours Next Back

These People Can Write Orders: • Doctor of medicine or osteopathy • Physician assistant • Nurse practitioner • Dentist • Optometrist Next Back

Non-Prescription or Over-the-Counter Medication • Commercially prepared • Original container • Non-alcohol based • Necessary for student to remain in school Next Back

Non-Prescription Medication Require: • Written parent permission & instructions • Can be faxed • Student name • Medication name • Medication dosage, frequency, route • Must provide own medication Next Back

Student Self-Medication • Requires no assistance • Requires no documentation that medication was taken • Grades K-8: Self-medication of prescription and nonprescription medication is not allowed except in cases where a student must carry such medication on his/her person or there is a MD order. • Policy states that with grades 9-12 paperwork needs to be completed for prescriptive and nonprescription medications (HE-26 & HE-28) • Cannot self-medicate Narcotics, Stimulants, or Barbiturates Next Back

Remember!Original Container • NO Baggies • NO Envelopes • NO Medication Boxes Next Back

Routes of Medication • Oral • Tablets, capsules, elixirs or suspensions • Topical • Skin, eyes, ears, nose • Inhaled • Mouth or nose Next Back

Oral Medication • Oral medicine should be followed with water • Obtain water from a clean source • Do not obtain water from sink where first aid provided (OR-OSHS 1910.1030 (2) ix & x) Next Back

Oral Medication • Tablets requiring cutting should be cut at home and sent to school • Parents should provide pill crusher if pills need to be crushed • Have parents provide calibrated spoon/cup if needed for liquid medication Next Back

Topical Medication Ointments • Apply to a clean surface • Do not apply with your bare hands • Use a cotton tipped applicator or gauze pad to apply medication Next Back

Topical Medication Eye Drops/Ointment • Administer with student laying down or head tilted back • Apply drops or ointment without touching container to eye or skin • Do not administer directly to eyeball • Apply to inner portion of eye, close to nose Next Back

Topical Medication Ear Drops • Lay child on side opposite of ear you are medicating • While gently pulling up and back on ear, instill correct number of drops • Do not touch tip of container to ear or skin • Leave child on side for a short time Next Back

Topical Medication Nose Drops • Have student lay with head back over a rolled pillow • Instill drops in nostril • Keep student in this position for a few minutes • Observe for signs of choking or vomiting Next Back

Inhaled Medication • Student should be capable of self-administering inhaler • If student continues to experience difficulty breathing 5 minutes after using inhaler • Call 9-1-1 Next Back

Five Rights • Right student • Right medication • Right dose • Right time • Right route Next Back

Handling Medications • Always wash your hands • Avoid touching medication • Wear gloves if placing medication in student’s mouth Next Back

Safe Storage and Handling • Store all medication in original containers in secure place • NEVER administer medications from an unlabeled container Next Back

Safe Storage and Handling • Store medications in a clean, locked cabinet • Narcotics, stimulants, and barbiturates should be counted upon arrival at school (May be counted with parent or trained school staff. HE-25) Next Back

Safe Storage and Handling • Medication should be brought to school and returned home by the parent. Do not allow students to carry medications home • Changes in medication instructions must be made by parent and/or physician in writing. DO NOT act on verbal requests • Only a licensed nurse can take verbal orders from a physician Next Back

Safe Storage and Handling • Refrigeration is necessary for some medications • Many liquid medications need to be shaken well Next Back

Disposal of Medication • Notify parent of unused medication • Any unclaimed medication should be disposed of in the toilet or regulated waste container in the presence of two staff members • Note parent contact and medication disposal on medication log (HE-20) Next Back

Handling The Three Most Common Unexpected Situations • Student does not come at scheduled time • Student refuses medication • Student vomits or spits out medication Next Back

Student Does Not Come at Scheduled Time • Send for Student • Document • Notify • Teacher • Parent • Nurse Next Back

Student Refuses Medication • Encourage • Document • Notify • Parent • Nurse Next Back

Student Vomits Or Spits Out Medication • Document • Notify • Parent • Check for symptoms of illness • Fever • Stomachache • Headache Next Back

Field Trips and Off- Campus Activities • Staff person trained in medication administration must accompany group if medications will be required-PLAN AHEAD! • Keep in original container • Sign medication out, then in to the assigned staff person • Document administration on return • Recommend notifying nurse two weeks prior to trip if medication training is necessary Next Back

Field Trip Supplies • Medication Log (HE-20) • Medication in original container • Hand cleaner • Drinking water • Safe container to transport Next Back

Side Effects & Allergic Reactions • All medication can cause side effects or allergic reactions • Know where EpiPens are kept and who is certified to use them • Teachers should be aware of students taking medication • Report promptly any unusual symptoms or behaviors to school nurse and parent Next Back

Medication Errors • Accidents Happen • Report medication errors immediately to school nurse and building administrator • Complete Incident Report Next Back

Dose not given Medication given to the wrong student Inaccurate dose or wrong medication Wrong time Incorrect route What Are Medication Errors? Next Back

Once LCSD has received a signed permission slip and medication, it is our responsibility To administer it appropriately and on time (30 mins before or after time on prescription) Monitor Medication supply Remember! Next Back

Record Keeping • Legal document • Use ink • Students full name and DOB(as in SM) • Medication Permission Form (HE-26) • Medication Log (HE-20) • Sign initials in log immediately after administering medication Next Back

Record Keeping • Only one student and one medication on each form • No white-out • If an error is made • Put a single line through it • Initial and date it • If there is a dose change • Begin a new line on the medication log Next Back

Retaining Medication Records • Send completed forms to the District Nurse • If medication is complete • The student moves • At the end of the school year • They will be filed in Student Health Folder • In SpEd file if student has an IEP Next Back

Confidentiality • Student medication files are CONFIDENTIAL • Access limited to school staff with a “need to know” and parents • Parent/Guardian authorization is required for release of information Next Back

Parent Communication • Avenues of communication to parents: • school newsletters • informational packets • registration packet • student handbooks Next Back

Dealing with Concerned Parent • Validate parent emotions • Share written information • Include school nurse and administrator • Set boundaries and ensure your own safety Next Back

Benefits for Parents • Trained staff will assist student • Clear, concise, accurate documentation is available for the parent/guardian, physician, nurse, and other authorized reviews • Only parent permission required for non-prescription medication Next Back

Establishing a Cooperative School Environment • Success requires a team effort • Include teacher in planning student’s medication needs Next Back

Staff Protection • School staff are protected by careful observation of regulations of the medication law, rules, district policy • Nurse’s responsibility is to provide proper training • Your responsibility is to follow the instruction Next Back

If you have any questions or concerns call a nurse before giving the medication Next Back

Medication Administration