Overview of medication issues and administration of medications in school Adebola E. Orimadegun

Healthy children Learn Better Important to know that: “children bring their whole life to school with them……and it doesn’t fit in a locker.” Many children require medications while at school, so that they can be active participants in the classroom

What does National Drug Policy says? No definitive policy on medication issues in school. Lessons for other policies: Only non-injectable medications are allowed outside standard clinic and hospital settings It is recommended that with the exception of an emergency situation, a licensed professional nurse administer injectable medication.

What does National Drug Policy says? Only trained staff can administer medication Designated school personnel are REQUIRED to receive appropriate training approved for the administration of prescription and non prescription medication.

Three Med Classifications Non-prescription medication Pupils/Student self-administered medications Prescription medications

Non-prescription Medications You must have Written Instructions from the pupil’s Parent/Guardian in order to give non-prescription medications

Non-prescription Medication Must have a signed parent/guardian permission form which includes: Pupil’s name Medication Medication dosage, frequency, and route Must be in the ORIGINAL CONTAINER

Non-prescription Medications May only be allowed if: The medication is necessary for the child to remain in school Excludes: Dietary Supplements Food Supplements Must be: Commercially prepared and non-alcohol

Pupil Self Administration For now no policy and procedures that govern self administration of medications in school In ORDER FOR A CHILD TO DO SO: Documented approvals are needed: Parent/Guardian School Administrator Student Doctor (if prescription)

Self Administration Requires no assistance Requires no documentation that the medication was taken Each school develops own policy to address self medication

Prescription Medications ONLY CERTAIN PEOPLE CAN WRITE a PRESCRIPTION: Doctor of Medicine Nurse Practitioner Dentist Optometrist

Prescription Medications…. Must be prepared and labeled by a pharmacist Only administer if required during school hours Must have a signed permission and instruction from parent Separate training is needed for any injectable medications

A Little More on Prescriptions Written Instruction from a physician (prescription label will meet this requirement) Original Pharmacy container Verbal doctors orders can only be taken by a licensed nurse

Giving Medications in school: the Five Rights Right Student Right Medication Right Dose Right Time Right Route

Handling Medications Get water from a clean source Always wash your hands! Avoid Touching the medications Wear gloves if placing medication in the pupil’s mouth

Handling Medications If tablets require cutting, it is good the parent needs to cut them at home prior to sending them to school Calibrated spoon/cup for liquid medications

Scheduling and timing of medications Stress the importance of reading and following the label instructions. Medication should be given within 30 minutes either side of the prescribed time.

Routes of Medications -Oral- Mouth Tablets Capsules Syrups, elixirs and suspensions

Route of Medication Topical Topical (on the outside of the body) Skin Eyes Ears Nose

Routes of Medication Inhaled Inhalation Nose Mouth

Safe Storage and Handling Store all medication in the original Container Store in a clean, locked cabinet File Cabinet Lock box Safe

Safe Handling…… Changes in medication instructions should always be made in writing from the parent/guardian Do not act on Verbal requests Refrigeration may be needed for some medications

Disposing of Medications Follow policy for disposal of unused or expired medications: Use the sink or toilet Regulated waste

Pupil’s Medication Record One sheet to sign in the supply and sign out One sheet to show what was administered by whom and when

Confidentiality Pupil’s medication files are confidential Only parent/guardian and authorized school staff should have access Parent/guardian authorization is required for release of information

Handling the Unexpected Student does not come at scheduled Med Time Send for them Document on the medication record Notify the parents via phone and in writing (forms are on the internet)

Pupil Refuses Medication Encourage the child to take the medication Document on the medication record Notify the parent/guardian in writing

Pupil Vomits or Spits Out Medication Document Notify Check for symptoms of illness Take temperature

Medication Errors Report the medication error immediately Parent/guardian Physician Nurse Building administrator

What Are Medications Errors Dose Omitted Medication given to wrong student Inaccurate dose or wrong medication Wrong time Incorrect route

Side Effects All medications have a potential for side effects If in doubt check medication fact sheets, call the pharmacy, or contact the school nurse Antibiotics-may cause a rash Analgesics-may cause an upset stomach

Side Effects Report promptly any unusual Symptoms Behaviors To the school nurse and parent

Dealing with Concerned Parents Validate parents concerns and emotions by listening and identifying a way to address their specific concern Share written information Include school nurse/administrator Set boundaries and ensure your own safety

Cooperative School Environment Success requires TEAM EFFORT

Cooperative School Environment Include the teacher in plans, send them a notice so that they are aware that medications are being administered Share information on medication times at the staff meetings Talk with school staff to help problem solve missed medication times

Thoughts School staff are protected by law if careful observation of the regulations are observed Any Questions

Thank you