Medication Administration

1. Medication Administration A Training for School Personnel School Health Services Crook County School District

2. The Law • The law covers only non-injectable medication. • Administrative rules were adopted by Oregon Department of Education. ORS 339.867 – 339.870 • Designated school personnel are now required to receive appropriate training annually for the administration of prescription and non-prescription medication.

3. The Law (cont.) • School districts may not require school personnel who have not received appropriate training to administer medication to students. • Administration of non-prescription medication by school personnel requires written instructions from the student’s parent. • School districts must adopt policies and procedures for this rule including policies which address students self medication.

4. Administrative Rule The definition of physician includes these people licensed by the respective licensing board in the State of Oregon or an adjoining state: • Doctor of Medicine or Osteopathy • Physician Assistant • Nurse Practitioner • Dentist • Optometrist • Naturopathic Physician

5. Administrative Rule • Separates prescription and non-prescription medication • Excludes dietary/food supplements • 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.

6. Training • Administrators are responsible for selecting regular and back-up staff. • Only trained staff can administer medication.

7. Prescription Medications • Does not include injectable drugs! • Must be prepared and labeled by pharmacist. • Administered only if required during school hours. • Requires signed permission and instruction from parent.

8. Prescription Medications • Requires written instructions from a physician (a prescription label meets this requirement). • Must be in original pharmacy container. • Verbal physician orders can only be taken by a licensed nurse.

9. Non-Prescription Medications • Age appropriate dosage (dosage must be consistent with the manufacturers guidelines) i.e. Ibuprofen. • Commercially prepared. • Non-alcohol based. • Necessary for student to remain in school.

10. Non-Prescription Medications • Require: • Written parent permission • Student name • Medication dosage, frequency, route • Must be in original container.

11. Five Rights • Right Student • Right Medication • Right Dose • Right Time • Right Route

12. Handling Medications • Obtain water from a clean source. • Do not obtain water from sink where first aid is provided. • Always wash your hands prior to giving medication. • Avoid touching medication. • Wear gloves if placing medication in student’s mouth.

13. Handling Medication • Tablets require cutting should be cut by the parent and sent to school. • Parents should provide pill crusher if pills need to be crushed. • Ask parents to provide calibrated instruments for measuring liquid medication (kitchen spoons are not accurate).

14. Routes Of Medication • Oral • Tablets • Capsules • Syrup, elixirs, and suspensions • Topical • Skin • Eyes • Ears • Nose • Inhaled • Mouth • Nose

15. Rectal medication administration and nebulizer treatments will not be taught in this training. They must be delegated in accordance with Oregon law.

16. Asthma Inhalers OSBA POLICY Supports the need for students to carry asthma inhalers

17. Safe Storage And Handling • STORE ALL MEDICATION in original containers in secure place. • NEVER administer medications from an unlabeled container. • NEVER empty medication into a plastic bag or other container

18. Safe Storage and Handling • STORE medications in a clean, locked cabinet. • CERTAIN medications require counting upon arrival at school. • REFRIGERATION is required for some medication.

19. Safe Storage and Handling • MEDICATION should be brought to school and returned home by the parent. Do not allow students to carry medications home without parent permission which must be documented. • CHANGES in medication instructions must be made by parent in writing. DO NOT act on verbal request. • FOLLOW district policy for disposal of unused medications e.g.: • Regulated waste

20. Documentation—If it’s not documented, it wasn’t done! • Documentation must be accurate and legible. • Document in blue or black ink. Never use pencil. • Never use white out. • If you make a mistake in entry, cross through and mark “ME” (mistaken entry).

21. Confidentiality • Student medication files are CONFIDENTIAL. • Access limited to authorized school staff and parents. • Parent authorization required for release of information.

22. Retaining Medication Records • Medication records should by filed at end of school year in: • Student health record for students without an IEP. • Special Education Files for students with an IEP.

23. Handling Unexpected Situations • Student does not come for medication at scheduled time. • Send for • Document • Notify parent • Student refuses medication. • Encourage • Document • Notify parent • Student vomits or spits out medication. • Document • Notify parent • Check for symptoms of communicable disease

24. Medication Errors • Report medication errors immediately to school nurse, building administrator, and parent • Omissions • Medication administered to wrong student • Inaccurate dose or wrong medication • Wrong time • Incorrect route

25. Side Effects • All medication has the potential for side effects. • Refer to “Medication Fact Sheet.” • Report promptly any unusual symptoms or behaviors to school nurse and parent.

26. Student Self-Medication • Requires no assistance. • Requires no documentation that medication was taken. • Student and parent to sign a self-medication agreement and have on file with Medication Authorization form in the office. • Controlled substances to be discussed with the School Nurse.

27. Field Trips or off-Campus Activities • Staff person trained in medication administration must accompany group if medications will be required. • Keep in original container. • Sign in and out. • Document administration on return.

28. Medication Alert • School staff are protected by careful observation of regulations of the medication law, rules, and their own district policy.