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Medication Administration Annual Review
A Training for School Personnel February 2007 Revised June 2008 Begin Exit
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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 Exit
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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 Next Back Exit
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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: Next Exit Back
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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 Next Exit Back
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Oregon Dept of Education
Initial training must occur face-to- face with a nurse Annual retraining can be completed online Next Exit Back
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Note: Only non-injectable medications are covered by this law
Nebulizer treatments, injections and rectal medication administration will not be taught in this training Next Exit Back
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Three Types Non-prescription medication Prescription medication
Student self-administered medications Next Exit Back
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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) Next Exit Back
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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 Next Exit Back
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Prescription Medications
Law requires school personnel to be responsible only for prescription medication scheduled to be given during school hours. Next Exit Back
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Prescription Medication
Does not include injectable drugs Must be prepared and labeled by a U.S. pharmacist and be in the original pharmacy container Next Exit Back
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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 Next Exit Back
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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 Next Exit Back
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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 Next Exit Back
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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 Next Back Exit
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Routes of Medication Oral Topical Inhaled
Tablets, capsules, elixirs or suspensions Topical Skin, eyes, ears, nose Inhaled Mouth or nose Next Exit Back
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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 Next Exit Back
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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 Next Exit Back
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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 Next Exit Back
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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 Next Exit Back
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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 Next Exit Back
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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 Next Exit Back
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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 Next Exit Back
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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 Next Exit Back
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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 Next Exit Back
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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 Next Exit Back
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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 Next Exit Back
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Handling Medications Always wash your hands Avoid touching medication
Wear gloves if placing medication in student’s mouth Next Exit Back
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Handling Medications Do Not leave meds unattended
Prepare for one student at a time Compare medication label with Medication Log Next Exit Back
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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 Next Exit Back
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Record Keeping Legal document Ink Students legal name and DOB
Medication Permission Form Medication Log Sign initials in log right after giving Next Exit Back
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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 Next Exit Back
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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 Next Exit Back
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Three Most Common Unexpected Situations
Student does not come at scheduled time Student refuses medication Student vomits or spits out medication Next Exit Back
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Student Does Not Come at Scheduled Time
Send for Student Document Notify Teacher Parent Nurse Next Exit Back
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Student Refuses Medication
Encourage Document Notify Parent Nurse Next Exit Back
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Student Vomits Or Spits Out Medication
Document Notify Parent Check for symptoms of illness Fever Stomachache Headache Next Exit Back
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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 Next Exit Back
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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 Next Exit Back
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What Are Medication Errors?
Dose not given Medication given to the wrong student Inaccurate dose or wrong medication Wrong time Incorrect route Next Exit Back
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Medication Errors Accidents Happen
Report medication errors immediately to district nurse and building administrator Nurse will contact parent Complete Accident/Incident Analysis Next Exit Back
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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 Next Exit Back
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Field Trip Supplies Copy of Medication Log
Medication in original container Hand cleaner Drinking water Safe container to transport Next Exit Back
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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 Next Exit Back
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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 Next Exit Back
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Parent Communication Avenues of communication to parents: Registration
Student Handbooks School Newletters Informational Packets Next Exit Back
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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 Next Exit Back
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Establishing a Cooperative School Environment
Success requires a team effort Include teacher in planning student’s medication needs Next Exit Back
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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 Next Exit Back
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Remember! NO Baggies NO Envelopes NO Medication Boxes Next Exit Back
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If you have any questions or concerns call a nurse before giving the medication
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Medication Administration Quiz
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Question #1 Never give medication sent to school in a baggie. True
False Exit
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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. Next question Exit
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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 Back Exit
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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 Exit
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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. Back Exit
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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. Next question Exit
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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 Exit
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Incorrect Oregon law states yearly instruction must be provided to designated school staff on the administration of medication. Back Exit
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Correct Oregon law states yearly instruction must be provided to designated school staff on the administration of medication. Next question Exit
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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 Exit
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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 Next question Exit
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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 Back Exit
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Question #5 Alcohol-based cough syrup can be given at school with written permission from a parent True False Exit
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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 Back Exit
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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. Next question Exit
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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 Exit
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Correct Prescription medication must be in the original container with a pharmacy label attached Only a licensed pharmacist can legally package and label medication Next question Exit
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Incorrect Prescription medication must be in the original container with a pharmacy label attached Only a licensed pharmacist can legally package and label medication Back Exit
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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 Exit
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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 Next question Exit
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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 Back Exit
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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 Exit
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Incorrect Law states school staff designated to administer medication must receive yearly training Back Exit
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Correct Law states school staff designated to administer medication must receive yearly training Next question Exit
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Question #9 Any student can carry and administer their own non-prescription medication if their parent writes it on the permission slip. True False Exit
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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 Back Exit
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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 Next question Exit
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Question #10 Students may carry and self-administer cough drops as long as their parent sends them with the student True False Exit
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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 Next question Exit
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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 Back Exit
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Question #11 All medication should be stored in a clean, locked cabinet. True False Exit
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Correct All medication should be stored in a clean, locked cabinet
Refrigerated medication must be stored in a locked container in the refrigerator Next question Exit
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Incorrect All medication should be stored in a clean, locked cabinet
Refrigerated medication must be stored in a locked container in the refrigerator Back Exit
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Question #12 If a student vomits after taking their medication, be sure to send a note home to the parent. True False Exit
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Incorrect If a student vomits after taking their medication Document
Observe for signs of an allergic reaction Check for signs of illness Contact parent Back Exit
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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 Exit
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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 Exit
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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 Back Exit
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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 Next question Exit
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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 Exit
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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. Back Exit
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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. Next question Exit
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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 Exit
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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 Back Exit
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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 Next question Exit
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Question #16 Teachers should know when their students are taking medication, in spite of confidentiality laws. True False Exit
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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 Next question Exit
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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 Back Exit
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Question #17 Always use pencil when recording medications so that you can make changes if a mistake is made. True False Exit
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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 Back Exit
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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 Next question Exit
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Question #18 At the end of the year, send all of the medication logs to Health Services at the DO. True False Exit
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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 Next question Exit
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Incorrect Send completed Medication Logs to the DO
If the medication is complete The student moves At the end of the school year Back Exit
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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 Exit
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Correct Medication is to be given within ½ hour before or after the designated time Next question Exit
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Incorrect Medication is to be given within ½ hour before or after the designated time Back Exit
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Question #20 True The 5 Rights of Medication Administration include:
Right Student Right Medication Right Dose Right Time Right Route True False Exit
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Correct If the person administering the medication always follows the “5 Rights”, it is unlikely an error will occur. Next Exit
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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 Back Exit
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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. Next
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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. Next
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