Washington County School District Health Services Training Module MEDICATION ADMINISTRATION Welcome to the Washington County Health Services Training Module This information is being made available to school personnel who may be called on to assist students with medication administration. Let’s get started!

Medication Law Utah Code 53A-11-601 Allows school personnel to administer medication if: 1 2 3 4 5 Aug Sept Oct Nov PRESCRIBING PRACTITIONER AUTHORIZATION: I have determined that the above described medications and routes of administration are medically necessary during school hours to maintain this child’s physical health. Signature_____________________ Date__________ PARENT/GUARDIAN AUTHORIZATION: The school authorized personnel have my permission to administer the above medication. I will also adhere to the following conditions of this agreement: Signature_____________________ Date_________ Utah Code 53A-11-601 Allows school personnel to administer medication if: Medication is properly identified (with a pharmacy label). Medication is kept safe in a locked unit by the school. Designated volunteer employees are trained by the School District Nurse The school maintains records of administration of medication Medication Authorization forms are signed by the parent or guardian and the physician School personnel and their employer are not civilly or criminally liable for any adverse reactions as a result of taking or discontinuing the medication so long as personnel are substantially compliant with the written prescription. Maintains Records of Administration Authorization Forms Signed Pharmacy Label Locked Unit Trained by School Nurse School Personnel are not civilly or criminally liable for adverse reactions, nor from discontinuing medication when compliant with the prescription

Medication Exceptions Utah Nurse Practice Act Rules: R156-31d-701a The following medications are not allowed to be delegating to school personnel Medications with known frequent side effects that can be life threatening Medications that require a student’s vital signs or oxygen saturation to be monitored before, during or after administration Medications that require nursing assessment or judgment prior to, or immediately after administration The first dose of a new medication or the first dose after a change in doses.

Washington County School District WCSD Policy 2320 establishes procedures for safe administration of medication to students and self administration by students during school hours in accordance with Utah Law 53A-11-601 Contact your nurse if you have concerns about a request authorization for medication. “WCSD has the right to refuse a request for medication administration” Read the slide Contact your school district nurse if you receive an unusual request for medication to be administered at school. She will make the final decision about the appropriateness of the medication

Forms to Give to Parents Give the following forms as appropriate: District policy 2320 Permission to Release Medical Records Medication Authorization(s) Single medication Multiple medications Asthma Allergy Anaphylaxis Asthma/Allergy/Anaphylaxis Glucagon & Self-Care Diabetes Diabetic Medical Management Plan(DMMP) If medication changes- new forms will be needed each time Read the slide If a parent/guardian refuses to sign the release of medical information, it is still possible to administer medication at school as long as the medical provider and parent/guardian sign the authorization.

Medication Files KEEP MEDICAL RECORDS IN ORGANIZED SYSTEM Contact your school nurse if you do not have a Confidential Medical Information Book EACH STUDENT FILE SHOULD INCLUDE: Individual Student Medication Calendar Medication Authorization(s) Permission to Release Health Record Individualized Health Care Plan for IEP, 504 or health conditions Read the slide If a student transfers to a new school in WCSD send the above files to the new school with a note to the school secretary to place them in the Confidential Medical Information Book If a student is moving out of the district place all of the above forms in the cumulative file. Twice a year the School Nurse will audit the medication files.

School District Nurse Notification Fax a copy of the following signed forms to the school nurse as soon as possible: Medication Authorization Permission to Release Medical Records Individualized Health Care Plan Read the slide Contact the school nurse for any errors/incidents or concerns regarding medication. Any medication incident should be documented on the Medication Incident Report

Medication The pharmacy label and the medication authorization form must be the same If there is a Generic substitute check the pharmacy label. It should list the name of the generic substitute Call the school nurse with any questions or concerns Read the slide

Medication Must Be Ready For Administration If the medical authorization orders ½ tablet the medication needs to come to school already cut in half Read the slide

Medication Must be kept in a locked unit If medication must be refrigerated, it will need to be placed in a locked unit in the refrigerator Locking cash boxes are usually large enough for medication in a refrigerator Read the slide

Medication Administration If the student fails to visit the office for a scheduled medication Call the student out of class Medication must be given within 30 minutes of the scheduled time, either 30 minutes before or after It is very important that medication is given daily, if a student misses several doses in a week contact the parent to help come up with a plan to encourage medication compliance

Medication Administration Be ALERT & FOCUSED while administering medication as distraction can lead to errors. Before administering check the FIVE RIGHTS of medication Right student Right medication Right dose Right time Right route (how it is given) Read the slide It is very important to be exact with medication, have another employee answer phones or deal with the needs of the office until the medication is administered.

Medication Administration Medication MAY NOT be shared with other students Call the parent when the medication supply is getting low Read the slide

Steps to Administer Medication Wash your hands Measure liquid on a flat surface and use a calibrated measuring cup Place tablets or capsules in a clean medication cup or in the students’ hand 4. Have the student take the medication in your presence 5. Provide a cup of water if needed Read the slide

Documentation Document the medication administration with your initials on the Individual Student Medication Calendar. If the medication is not given use one of the following codes: SA= Student absent NS= No show( called, but did not come) NM= No medication available EO= Early out day DC= Discontinued (Write DC one time, then cross out remaining school days on calendar) Documentation is part of administering medication and must completed daily.

Documentation (continued) Document daily on the medication calendar If it is not documented, it is considered “not done” by law. Document any conversations with the parent and student on the bottom section and back of the Individual Student Medication Calendar Read first two bullets If medication is not recorded the law interprets it as neglect of our responsibility and the District could be held liable. Read 3rd bullet If a parent/guardian is upset or concerned about the medication, contact the school district nurse and she will discuss it with the parent.

2009-2010 INDIVIDUAL STUDENT MEDICATION CALENDAR □ RN NOTIFIED: Faxed Form 351 and Form 352 to the ATTN of District Nurse Student___________________________ School_______________________Grade_________ DOB_________________ Medication_________________________Dose____________Time_____________ Route __________________________ Date started________________ Date discontinued_______________Discontinued by____________________________ Medication disposed of (5 days after DC): Date___________ Initials______ Witness initials_______________________ Codes: Initial= Given SA=Student Absent NS=No Show NM=No Med Available DC=Discontinued MONTH 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 August September October November December January February March April May June July Date & initial comments on bottom of this page & on the back.

Medication Incidents A Medication incident report must be completed when: An error is made in medication administration An adverse reaction is observed There is a confrontation with the student or parent regarding administration of medication Send or fax incident report to the school nurse labeled: CONFIDENTIAL The medication incident report is constructed to walk you through the necessary steps, and will identify those persons whom you should contact. Read the slide

Disposing of Medication When medication is discontinued call parent to pick it up. You may dispose of medication that has not been picked up after 5 days notice, by flushing it or placing it in a small sharps container. Initial on the Medication Calendar and have a witness initial with you. Read first 2 bullets Medication is costly to most families, and it preferable that the parent/guardian pick it up at school Read the 3rd bullet

Authorization to Administer Medication at School You will be authorized to administer medication under the delegation of the School Nurse after: Completing this training module and Take the test that goes with the module. Complete and sign the Medication Administration Guide.

Washington County School District Health Services This concludes the Health Services Training Module Please follow the instructions below to complete a short quiz. Make a copy of the test for this module then answer the questions. You can also make a copy of this power point to assist you with the test. 3. Check the answers. 4. Send a copy of your answers to the school nurse. Thank you for taking the time to learn how to care for students who are in need of medication at school. Washington County School District Health Services