School Board Of Sarasota County Field Trip Medication Administration Training

Objectives The staff member who successfully completes the field trip medication training will be able to: List the 8 R’s of medication administration. Communicate student/s special needs or medication requirements. State proper hand-washing technique. State proper medication storage. Accurately receive, count, and document the exchange of medication. Accurately document the administration of medication. Identify what constitutes a “medication/treatment variance”. Understand the process for reporting a medication/treatment variance. Complete the Field Trip Medication Administration Skills Checklist with the RN.

State Statues under Section1006.062 Staff may assist students in the administration of prescribed medication provided that: There is a procedure in place for training school personnel by a registered nurse, a physician or a physician’s assistant. There is a signed Medication/Treatment Authorization Form signed by the physician and parent. Each prescribed medication to be administered by school personnel is received, counted, and stored in its original container.

What May Not be Given! Dietary supplements such as vitamins, minerals, herbs, etc. (These are not approved by the FDA.) Amino acids, enzymes organ tissues, metabolites, extracts and concentrates. Controlled narcotic medication for severe pain management. (Use of these medications for students with Chronic Conditions will be considered on a case by case basis as determined by your school RN.) No over the counter medication is given without a parental request on the Emergency Medical/Treatment Field Trip Consent Form and a Medication/Treatment Authorization Form (M/TAF) from the child’s physician.

Label on the Prescription Bottle The label must have this information: Student’s name Name of medication Directions concerning dosage (route, dose, frequency) Time of day medication is taken Health care provider’s name Date of prescription Expiration date Pharmacy label must match physician’s order

Techniques for Administering Medications To ensure the safety of students requiring medications, the 8 Rights of Medication Administration must be followed. 1. Right student 5. Right route 2. Right medication 6. Right expiration date 3. Right dose 7. Right documentation 4. Right time 8. Right of student to refuse

Techniques for Administering Medication continued: Wash hands before giving the medication. (Hand sanitizer may be used.) Ask the student to state first and last name (do not prompt).  Small children will often answer to other names.  It is important that the student is correctly identified before medication is given.   Compare the label on the medication container with the M/TAF for the following information: right student, right medication, right dose, right time, and right route. Always check three times to be sure that the child is receiving the correct medication.  Check the student’s name on the container of medication when it is removed from your keep safe place, just before the child takes the medication, and before it is returned.  Check the expiration date on the medication container to be sure that it has not expired. 

Giving Oral Medication Have student take a few sips of water before giving medication to aid in swallowing. Measure liquid medication in a disposable plastic calibrated cup or pharmacy provided measuring device (this procedure will be demonstrated to you by the school RN). Shake suspensions before pouring. Do not crush tablets unless approved by the doctor. Make sure the medication is swallowed---check the child’s mouth. Do not put the medication in your hands, use the bottle cap.

How Students Are to Use Inhaled Medication Remove the cap. Connect the inhaler to the holding chamber. 2. Student is to hold the inhaler like the letter “L” with thumb on the bottom and fingers on the top. 3. Student to shake inhaler 3 to 4 times. 4. While standing (preferably), student to exhale as much air as possible with head tipped back slightly. 5. Student to close lips around the mouthpiece of spacer, keeping spacer level (closed mouth method), or close lips around the mouthpiece of the inhaler, keeping inhaler level (closed mouth method). 6. Student to press down on the inhaler to release the medication and breathe in slowly. 7. Student to hold breath for 10 seconds if possible.

Inhaled Medication continued Student to breath out slowly with lips almost together. Wait one minute. 10. Repeat steps if student is supposed to take more than one puff. 11. Student should rinse mouth after using inhaler.

Inhaler with spacer

Security Issues All medication must be in the original container with the student’s name, dosage, directions for administration and current date. Parents may provide the school with a properly labeled duplicate prescription container for field trips. The staff person accompanying the student will be responsible for security of the medication and for medication administration. Medication cannot be administered by volunteer staff or parent chaperones other than the student’s own parent/guardian. Certification to administer medication on field trips, applies ONLY to field trips, and does not entitle the person to administer medications elsewhere on the school campus.

Field Trip Procedure PRIOR TO THE FIELD TRIP, THE STAFF PERSON WILL: Inform the health room aide at least three weeks in advance of the scheduled field trip date. (This time will allow for medication training including child-specific training for students with diabetes, students with injectable medications (EpiPen) and students with a nebulizer treatment.) Have received the field trip medication administration training. Go to the health room to collect all medication needed on the trip. Check the label of the medication container for each student and compare it with the information on the M/TAF. Count the medication along with the health room aide and document on the Medication/Treatment Administration Log (M/TAL).

Field Trip Procedure continued: Quantity of Medication Date of Transport # Received # Returned # on hand total Signature field trip 10/2/07 10 Holly Healthy / Polly Pill Sign his/her name next to the health room aide on the back of the Medication Treatment/Administration Log (MTAL). Place the medication and your copies of the MTAF and MTAL in a fanny pack, which will remain with you (or the staff person responsible for giving medication). If liquid medication, remember to take a device for measuring.

DURING THE FIELD TRIP THE STAFF PERSON WILL: Assist each student with the administration of his/her medication at the time it is due (must be given within one hour of the ordered time). Write the time medication was given and your initials on the front of the copied M/TAL under the correct month/day. 1 2 3 4 5 6 7 Aug Sep Oct 10 AM P.P. Print your initials and sign your name on the front of the copy of the MTAL Persons Administering Medication/Treatment: Initials PP Full Name Polly Pill Initials Full Name

Quantity of Medication UPON RETURN FROM THE FIELD TRIP, THE STAFF PERSON WILL:  Bring the medication containers/inhalers/EpiPen back to the health room.  Re-count, along with the health room aide, the number of medication (s) returned.  Sign/date the back of the log after quantity has been documented by the aide. Quantity of Medication Date of Transport # Received Returned On Hand Total Signature Field Trip 10/2/07 10 Holly Healthy / Polly Pill 8

If the medication is not given as ordered: The staff person responsible for giving the medication will notify the principal, school RN, and parent/guardian immediately. If no parent contact is made, a note must be sent home to the parent describing the event. The school RN or principal can assist with content and appropriate documentation on the note. The staff person will properly document the variance on the M/TAL and Medication/Treatment Variance form (the health room aide has this form). Once completed, the variance form is sent to the School Health office at the Landings.

Medication Administration on Overnight Field Trips The staff person responsible for the overnight trip should ask the parent if their child requires medication during the time of the field trip. If the student requires medication, the parent must submit a signed M/TAF (unless already on file at the school). Ask the parent to bring the medication to the school health room at least 24 hours before the trip (unless already available in the health room). All of the same medication guidelines outlined in this document apply.

Assessment After viewing this presentation, you should: Know & understand the information listed in the objectives on the first slide of this presentation. Be ready to make an appointment to complete the Field Trip Administration Skills Checklist with the school RN. Have the knowledge necessary to be able to give medications on a field trip.