1. Medication Administration Annual Review
A Training for School Personnel February 2007
Revised June 2008
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2. Welcome to KCSD annual medication administration re-training
Welcome to KCSD 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 one of the nurses. Please read all of the information and complete the quiz. Following the quiz, there is a survey. This information is required and will assist in improving this course and developing others. You must include your name, building, and date. This information is required for our records. If this is your first time completing this course, allow 1/2 hour to do so. Next Back
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3. 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 to and OAR
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4. The Law
Administrative rules were adopted by the Oregon Department of Education in 1997, and amended by the legislature in 2007.
School districts must adopt policies and procedures for this rule including policies which address student self medication.
The law in Oregon which elates to administering medication to students by school personnel was amended in 1997 (See Appendix A)
The siginificant changes to this law include dthe following:
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5. 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
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6. Oregon Dept of Education
Initial training must occur face-to- face with a nurse
Annual retraining can be completed online
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7. Note: Only non-injectable medications are covered by this law
Nebulizer treatments, injections and rectal medication administration will not be taught in this training
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8. Three Types Non-prescription medication Prescription medication
Student self-administered medications
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9. Non-Prescription Medication
Commercially prepared
Original container
Non-alcohol based
Necessary for student to remain in school
Includes cough drops and antacids (e.g. Tums)
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10. Non-Prescription Medication
Require:
Written parent permission & instructions
Can be faxed
Student name
Medication name
Medication dosage, frequency, route
Must provide own medication
Never give medication that was not provided by the parent due to the risk of allergic reactions
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11. Prescription Medications
Law requires school personnel to be responsible only for prescription medication scheduled to be given during school hours.
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12. Prescription Medication
Does not include injectable drugs
Must be prepared and labeled by a U.S. pharmacist and be in the original pharmacy container
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13. Prescription Medication
Requires written instruction from a physician
Prescription label meets this requirement
Requires signed permission and instruction from parent
Medication Permission Form
New medication permission form must be completed each year
Administered only if required during school hours
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14. These People Can Write Orders:
Doctor of medicine/osteopathy/naturopathy
Physician assistant
Nurse practitioner
Dentist
Optometrist
The definition of physician includes these people licensed by the respective licensing board in the state of Oregon or an adjoining state.
OAR’s :
Expands definition of physician
Defines medication as prescription and non-prescription
Defines authorized training
Outlines parental instruction
Defines physician instruction
Outlines school district policy requirements
Excludes dietary/food supplements
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15. Student Self-Medication
Student must be able to carry and self-medicate, without assistance
No staff documentation necessary
Must be in original container
May only carry one days supply at a time
Student must be developmentally able
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16. Self-Medication Changes for 2008-2009
Can self-medicate at all schools
Requires Self-Medication Permission Form
Requires medical order
Only for prescription medication
Can be on the label
Requires principal permission
Can be revoked
Requires parent to provide back-up inhalers & EpiPens to be kept in the office
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17. Routes of Medication Oral Topical Inhaled
Tablets, capsules, elixirs or suspensions
Topical
Skin, eyes, ears, nose
Inhaled
Mouth or nose
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18. 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
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19. 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
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20. 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
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21. 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
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22. 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
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23. 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
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24. Inhaled Medication
Student should be capable of self-administering inhaler
If student continues to experience difficulty breathing 5 minutes after using inhaler
Call parent and/or 9-1-1
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25. Five Rights Right student Right medication Right dose Right time
Always ask the students name
Right medication
Check the label
Right dose
Right time
Can be given 30 min before or after the time stated on the label
Right route
Check the instruction on the label
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26. Safe Storage and Handling
Store medications in a clean, locked cabinet
NEVER administer medications from an unlabeled container
Narcotics, stimulants, and barbiturates should be counted upon arrival at school
May be counted with parent or trained school staff
Check with district nurse if you are unsure
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27. 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
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28. Safe Storage and Handling
Refrigeration is necessary for some medications
Many liquid medications need to be shaken well
Beginning refrigerated meds need to be locked
District will provide lock boxes
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29. Handling Medications Always wash your hands Avoid touching medication
Wear gloves if placing medication in student’s mouth
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30. Handling Medications Do Not leave meds unattended
Prepare for one student at a time
Compare medication label with Medication Log
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31. Disposal of Medication
Notify parent of unused medication
Any unclaimed medication should be placed in sealable container in the presence of two staff members
Prescription Medication must be counted and the number of pills documented
Bring sealed container to DO during secretary check-out
Note parent contact and medication disposal on Medication Log; sign by both staff members
Unused medication should be picked up by parent, not sent home with student
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32. Record Keeping Legal document Ink Students legal name and DOB
Medication Permission Form
Medication Log
Sign initials in log right after giving
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33. Record Keeping Only one student 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
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34. Retaining Medication Records
Send completed forms to the DO
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
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35. Three Most Common Unexpected Situations
Student does not come at scheduled time
Student refuses medication
Student vomits or spits out medication
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36. Student Does Not Come at Scheduled Time
Send for Student
Document
Notify
Teacher
Parent
Nurse
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37. Student Refuses Medication
Encourage
Document
Notify
Parent
Nurse
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38. Student Vomits Or Spits Out Medication
Document
Notify
Parent
Check for symptoms of illness
Fever
Stomachache
Headache
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39. 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 district nurse and parent
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40. Prevent Errors Take your time Do not allow yourself to be rushed
Work with one student at a time
Always follow the “5 rights”
Record medication immediately after giving on the Medication Log
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41. What Are Medication Errors?
Dose not given
Medication given to the wrong student
Inaccurate dose or wrong medication
Wrong time
Incorrect route
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42. Medication Errors Accidents Happen
Report medication errors immediately to district nurse and building administrator
Nurse will contact parent
Complete Accident/Incident Analysis
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43. Field Trips and Off- Campus Activities
PLAN AHEAD!
Staff person trained in medication administration must accompany group if medications will be required
Document administration on a copy of the Medication Log while on field trip and on the original when you return
Recommend notifying nurse two weeks prior to trip if medication training is necessary
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44. Field Trip Supplies Copy of Medication Log
Medication in original container
Hand cleaner
Drinking water
Safe container to transport
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45. Confidentiality Student medication files are CONFIDENTIAL
Access limited to school staff with a legitimate “need to know”
Parent/Guardian authorization is required for release of information
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46. Remember!
Once KCSD 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
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47. Parent Communication Avenues of communication to parents: Registration
Student Handbooks
School Newletters
Informational Packets
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48. Dealing with Concerned Parent
Validate parent emotions
Remind them - student safety is the priority
Share written information
Include district nurse and administrator
Set boundaries and ensure your own safety
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49. Establishing a Cooperative School Environment
Success requires a team effort
Include teacher in planning student’s medication needs
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50. 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
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51. Remember!
NO Baggies
NO Envelopes
NO Medication Boxes
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52. If you have any questions or concerns call a nurse before giving the medication
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53. Medication Administration Quiz
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54. Question #1 Never give medication sent to school in a baggie. True
False
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55. Correct
All medication must be in the original container properly labeled with the name of the student, name of the medication, dose, route, and frequency of administration.
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56. Incorrect
Law states all medication must be in the original container properly labeled with the name of the student, name of the medication, dose, route, and frequency of administration
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57. Question #2
If a parent calls saying the doctor has increased the dose from one pill to two, always follow the parent’s instructions.
True
False
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58. Incorrect
Medication must be given as directed on the prescription label. Written instructions from the doctor or a new prescription label are required to change the dose.
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59. Correct
Medication must be given as directed on the prescription label. Written instructions from the doctor or a new prescription label are required to change the dose.
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60. Question #3
Once a staff member has been trained to give medication by the nurse, they only need more training if the laws regarding medication administration change.
True
False
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61. Incorrect
Oregon law states yearly instruction must be provided to designated school staff on the administration of medication.
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62. Correct
Oregon law states yearly instruction must be provided to designated school staff on the administration of medication.
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63. Question #4
A good way to assure the appropriate students receive their medication each day is to keep a list on the cabinet or refrigerator
True
False
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64. Correct
Student medication information is confidential and should be shared only with staff who have a legitimate “need to know”
Posting such information where students, parents, general staff can view it is a breech of confidentiality
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65. Incorrect
Student medication information is confidential and should be shared only with staff who have a legitimate “need to know”
Posting such information where students, parents, general staff can view it is a breech of confidentiality
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66. Question #5
Alcohol-based cough syrup can be given at school with written permission from a parent
True
False
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67. Incorrect
The law defines non-prescription medication as: commercially prepared, non-alcohol based medication to be taken at school that is necessary for the child to remain in school. This includes eyes, nose and cough drops, cough suppressants, analgesics, decongestants, antihistamines, topical antibiotics, anti-inflammatories and antacids that do not require written or oral instructions from a physician. Non-prescription medication does not include dietary food supplements
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68. Correct
The law defines non-prescription medication as: commercially prepared, non-alcohol based medication to be taken at school that is necessary for the child to remain in school. This includes eyes, nose and cough drops, cough suppressants, analgesics, decongestants, antihistamines, topical antibiotics, anti-inflammatories and antacids that do not require written or oral instructions from a physician. non-prescription medication does not include dietary food supplements.
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69. Question #6
If a parent sends a pill bottle with the students name on it to school and keeps the original pill bottle at home, it is OK to give the medicine.
True
False
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70. Correct
Prescription medication must be in the original container with a pharmacy label attached
Only a licensed pharmacist can legally package and label medication
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71. Incorrect
Prescription medication must be in the original container with a pharmacy label attached
Only a licensed pharmacist can legally package and label medication
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72. Question #7
When a parent asks you to give their child two Children’s Tylenol for a headache, it is OK to do so if you have the medicine.
True
False
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73. Correct
Oregon law requires written permission and instruction from the student’s parent to administer non-prescription medication
It is the parent’s responsibility to provide a student’s medication
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74. Incorrect
Oregon law requires written permission and instruction from the student’s parent to administer non-prescription medication
It is the parent’s responsibility to provide a student’s medication
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75. Question #8
When the trained medication person is absent, the principal can have another staff member give medicine even if they have not been trained.
True
False
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76. Incorrect
Law states school staff designated to administer medication must receive yearly training
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77. Correct
Law states school staff designated to administer medication must receive yearly training
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78. Question #9
Any student can carry and administer their own non-prescription medication if their parent writes it on the permission slip.
True
False
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79. Incorrect
Any student may carry and self-medicate non-prescription medication with:
Written parental permission Self-Medication Permission Form
Principal permission
Medication must be in original container
Student may only carry one days supply of medication at a time
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80. Correct
Any student may carry and self-medicate non-prescription medication with:
Written parental permission Self-Medication Permission Form
Principal permission
Medication must be in original container
Student may only carry one days supply of medication at a time
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81. Question #10
Students may carry and self-administer cough drops as long as their parent sends them with the student
True
False
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82. Correct
Cough drops and antacids (e.g. Tums) are considered non-prescription medication and require:
Student to provide their own medication
Written parental permission & instructions to include:
Student name
Medication name
Medication dose, frequency, route
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83. Incorrect
Cough drops and anti-acids (Tums) are considered non-prescription medication and require:
Student to provide their own medication
Written parental permission & instructions to include:
Student name
Medication name
Medication dose, frequency, route
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84. Question #11
All medication should be stored in a clean, locked cabinet.
True
False
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85. Correct All medication should be stored in a clean, locked cabinet
Refrigerated medication must be stored in a locked container in the refrigerator
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86. Incorrect All medication should be stored in a clean, locked cabinet
Refrigerated medication must be stored in a locked container in the refrigerator
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87. Question #12
If a student vomits after taking their medication, be sure to send a note home to the parent.
True
False
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88. Incorrect If a student vomits after taking their medication Document
Observe for signs of an allergic reaction
Check for signs of illness
Contact parent
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89. Correct
If a student vomits after taking their medication
Document
Observe for signs of an allergic reaction
Check for signs of illness
Contact parent
Next question
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90. Question #13
When an eighth grade student does not come for their medication, it is their own problem; they are old enough to be responsible.
True
False
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91. Incorrect
Once we have received medication and a signed permission slip from a parent, we are responsible for getting the medication to the student within ½ hour of the designated time
If a student does not come for scheduled medication
Send for the student
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92. Correct
Once we have received medication and a signed permission slip from a parent, we are responsible for getting the medication to the student within ½ hour of the designated time
If a student does not come for scheduled medication
Send for the student
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93. Question #14
When a student requiring medicine is going on a field trip, put their pills in a zip-lock bag with the students name and instructions, and give them to the teacher.
True
False
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94. Incorrect
Prescription medication must be in its original container with a proper pharmacy label attached
non-prescription medication must be in its original container, labeled with the students name
Anyone dispensing medication at school must receive annual, ODE approved training.
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95. Correct
Prescription medication must be in its original container with a proper pharmacy label attached
non-prescription medication must be in its original container, labeled with the students name
Anyone dispensing medication at school must receive annual, ODE approved training.
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96. Question #15
A student is given the wrong medication in error. The best thing to do is make the student vomit the medicine.
True
False
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97. Incorrect Never induce vomiting
Medication errors must be reported to the nurse immediately
Medication errors include:
Failing to give a dose
Giving medication to the wrong student
Giving medication at the wrong time
Giving the wrong medication or the wrong dose
Giving the medicine by the wrong route
If a nurse is not immediately available, you may call Poison Center
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98. Correct Never induce vomiting
Medication errors must be reported to the nurse immediately
Medication errors include:
Failing to give a dose
Giving medication to the wrong student
Giving medication at the wrong time
Giving the wrong medication or the wrong dose
Giving the medicine by the wrong route
If a nurse is not immediately available, you may call Poison Center
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99. Question #16
Teachers should know when their students are taking medication, in spite of confidentiality laws.
True
False
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100. Correct
Teachers have a “legitimate educational interest” in students taking medications
All medication has the potential to cause side effects
All medication has the potential to cause an allergic reaction
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101. Incorrect
Teachers have a “legitimate educational interest” in students taking medications
All medication has the potential to cause side effects
All medication has the potential to cause an allergic reaction
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102. Question #17
Always use pencil when recording medications so that you can make changes if a mistake is made.
True
False
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103. Incorrect Medication records are legal documents
Must be written in ink
When you write on the medication log, initial what you have written
If your initials are on the log, place your initials and signature in the appropriate spot on the bottom of the log
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104. Correct Medication records are legal documents Must be written in ink
When you write on the medication log, initial what you have written
If your initials are on the log, place your initials and signature in the appropriate spot on the bottom of the log
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105. Question #18
At the end of the year, send all of the medication logs to Health Services at the DO.
True
False
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106. Correct Send completed Medication Logs to the DO Next question
If the medication is complete
The student moves
At the end of the school year
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107. Incorrect Send completed Medication Logs to the DO
If the medication is complete
The student moves
At the end of the school year
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108. Question #19
When the prescription label says to give the medicine at 12:00 and lunch is at 11:45, it is OK to give before lunch.
True
False
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109. Correct
Medication is to be given within ½ hour before or after the designated time
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110. Incorrect
Medication is to be given within ½ hour before or after the designated time
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111. Question #20 True The 5 Rights of Medication Administration include:
Right Student
Right Medication
Right Dose
Right Time
Right Route
True
False
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112. Correct
If the person administering the medication always follows the “5 Rights”, it is unlikely an error will occur.
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113. Incorrect Right Student-always ask their name, even if you know them
Right Medication-read the prescription label and compare it to the medication log
Right Dose-give the exact amount specified by the physician on the label
Right Time-check the medication log for the time it is to be given. Up to 30 minutes before or after the prescribed time is OK
Right Route-always check the label which will tell you if it is to be taken by mouth, rubbed on the skin, or put in an ear
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114. References
Oregon Department of Education. Accessed April 21,2007.
Oregon Administrative Rules, Chapter Administration of Prescription and Nonprescription Medication to Students (2005).
Oregon Revised Statutes, Chapter Administration of medication to students; rules (2001).
Perry, A. G. & Potter, P. A. (2006). Clinical nursing skills & techniques (6th ed.). Philadelphia: Mosby.
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115. You have now completed the review
You have now completed the review. Click next to submit the results and complete a survey. The survey must be completed to document your training.
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