1. Vista Unified School District Health Services Medication Administration Training For School Personnel
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2. Healthy Kids Learn Better
Many students require medications while at school, so that they can be active participants in the classroom. Laws ensure their needs are met.
“Kids bring their whole life to school with them……and it doesn’t fit in a locker.”

3. Your role
This presentation was developed to allow you to have regular training on medication administration at your convenience.
There is a post-test at the end. Print the test and answer the questions.
Leave the completed answer sheet for your School Nurse to review.

4. The Law: California Ed Code Section 49423
The California Department of Education issued a Program Advisory On Medication Administration
The Advisory provides recommendations to local educational agencies on all aspects of med administration
All info in this training is from the Advisory

5. School personnel can administer meds if they:
Are designated by the site administrator to do so
Are trained and supervised by a credentialed school nurse or physician
Training is reviewed regularly
They are willing to do so

6. Things to Remember
Site administrators should select REGULAR and BACK-UP staff to be trained
ONLY trained staff can administer medication
You should not be required to administer medications until you have received training

7. Paperwork
Three forms are required before a medication is given at school
AUTHORIZATION FOR MEDICATION ADMINISTRATION
WRITTEN STATEMENT BY PARENT OR GUARDIAN
MEDICATION LOG

8. Is valid for one school year only
Vista Unified School District AUTHORIZATION FOR MEDICATION ADMINISTRATION (Education Code Section 49423)
Must be signed by a health care provider for ALL medications given at school, even Over-The-Counter medicines
Is valid for one school year only
If the student’s medication, dosage, or provider changes during the school year, a new form must be completed and signed

9. All who authorize meds must be licensed in the state of California
Providers can be:
Physicians
Dentists
Optometrists
Podiatrists
Nurse practitioners
Certified nurse midwives
Physician assistants

10. The Authorization, continued
Our VUSD Authorization for Med Admin form meets all state standards when completed
A faxed Authorization form is acceptable
Telephone orders are not acceptable
The medication, dose, time, and other instructions should be clear

11. Written Statement from the Parent or Guardian
Side 2 of the health care providers Authorization form
Only medication needed during the school day should be administered at school, except in special cases
The parent or guardian will provide all necessary medication, supplies, and equipment

12. Parent authorization, continued
The parent is to notify the school if there is a change in the medication, health status, or health care provider.
Parent is to provide a new AUTHORIZATION form to reflect any changes

13. Bringing meds to school
The parent should deliver to school all medications, except medications that the student is authorized to carry and self-administer.
School staff are to count ADHD and controlled medications with the parent and document the amount on side 2 of the med log

14. Some Considerations
Prescription meds are to be in a container labeled by a pharmacist listing the student’s name, provider’s name, medication, dose, and directions for use
Over-the-counter medication must be in the original container

15. Some parent rights
A parent should not be required by school officials to administer medication to their child as a condition of receiving any services
A written statement from an authorized health care provider is not required when a parent administers medication to their own child in school

16. Remember
Do not accept a medication if the provider’s AND parent authorizations are not received (teach this to your coworkers)
You may choose to offer to assist parents by faxing providers
Invite the parent to come and give the medication until all paperwork is received
Before giving medications, make sure a separate MED LOG is prepared for EACH medication

17. Our MEDICATION LOG meets all state standards when we complete it
STUDENT NAME___Jones, Jane ______________ MEDICATION __Albuterol TIME _11:30am__________________________ SPECIAL INSTRUCTIONS Every 4 to 6 hours as needed for cough and 15 mins before PE
Our MEDICATION LOG meets all state standards when we complete it
MEDICATION -The authorization form and bottle should match.
Be sure to note the entire name, for example Adderall XR is not the same as Adderall
The bottle may list generic names and the authorization lists brand names. Call your school nurse for info
TIME -The exact time authorized by the provider
SPECIAL INSTRUCTIONS -be sure to list ALL that is written on the Authorization form.

18. DOSE -The number of milligrams, teaspoons, number of puffs, etc
DOB __ ___________ DOSE __2 puffs____ ROUTE ___inhaled_______ _____________________________________
DOSE -The number of milligrams, teaspoons, number of puffs, etc
ROUTE -may be oral (by mouth,) topical (cream or ointment,) inhaled (asthma inhaler,) eye drop, ear drop

19. Medication Administration Procedure
Follow a standard routine every time to minimize errors
Remember the 5 rights
Right Student
Right Medication
Right Dosage
Right Time
Right Route
Practice the 3 checks (next slide)

20. Medication Administration Procedure
Check #1 –Make sure the MEDICATION LOG MATCHES the AUTHORIZATION form
Check #2 –As you pick up the bottle, READ THE BOTTLE LABEL to see that it MATCHES the MED LOG
As you check the log, look at the date to be sure the med wasn’t given already by a coworker
Do check #3 of the LABEL of the BOTTLE again as you pour the med

21. Med Administration, continued
Give medications to only one student at a time
Check the student for unusual behavior or conditions
Explain the procedure to the student
Afterward, verify that the med was taken

22. Timing
Have a plan for calling students to come for meds so they are not missed or late
30 minutes before or after the time authorized is considered OK
It is considered an error if later or earlier
If more than 30 minutes late, talk to the parent before giving it

23. Documentation
Immediately after giving the med, document on the MEDICATION LOG
Put your initials and the time in the square for the month and date
Make sure you sign and initial the bottom of each med log once
SIGNATURE/INITIALS __P. Nichols______
__PN___________
Your school nurse will review and sign in the column to the right.

24. More on documentation
Document on side 2 of the med log all conversations, concerns, medication counts, or incidental information
IF for some reason a daily medication is not given, indicate in the box why it was not.

25. As needed, or PRN
Before giving “as needed meds”, be very sure to check the med log box to see if it was given recently
If needed early in the school day, consider phoning the parent to see if the med was given at home.
If needed again too soon after being given, this may indicate a worsening problem that needs doctor’s evaluation.

26. Things to remember
Contact a school nurse if the physician’s order is not clear, parent request differs from the physician’s orders, or you have any questions or concerns
Let the teacher know a student will be taking a medication
Let your site school nurse know of any new medications

27. If Errors Happen Stay calm and keep the student with you
Call a school nurse, who will advise about the particular medication
Notify your site administration
Call the student’s parent and explain what happened
Fill out a student accident report

28. What Are Medications Errors
Dose is omitted
Medication given to wrong student
Inaccurate dose
Wrong medication
Wrong time
Incorrect route

29. “Special Needs” programs
If a special program classroom is not accessible to the Health Office, medication can be kept in a locked cabinet or drawer
The medication cabinet or drawer is to remain locked at all times except when individual medication is administered by a trained individual

30. Students may self administer meds
When self-administration is authorized by the health care provider
When the parent gives written consent
When the student is competent to do so
Please be sure to let the school nurse know when students are authorized to self administer

31. Handling medications
Avoid touching medications; pour it into the bottle cap or the cup
Wear gloves if placing medication in the students mouth or administering eye or ear drops or topical meds
Hand washing is the single most important practice for preventing transmission of infectious organisms

32. Some Considerations
Use a calibrated spoon/cup to measure doses of liquid medications
If pill splitting is required,
the pill needs to be scored
split in half only
use a commercial pill-splitter

33. Student Refuses Medication
Encourage the child to take the medication
Document on the medication log
Notify the parent/guardian right away

34. Student Vomits or Spits Out Medication
Check for symptoms of illness, for example, take temp (wait 5 minutes after vomiting)
Notify the parent
Document on side 2 of the med log

35. Side Effects All medications have a potential for side effects
Antibiotics-may cause a rash
Analgesics-may cause an upset stomach
Promptly report any unusual symptoms or behaviors to the school nurse and parent

36. Field Trip & Off Campus Activities
Students have the right to participate in ALL school related activities
A trained staff member is to accompany students and carry the medications in a secure manner
Document “FT” on the med log
Document on Side 2 the name of the person who administered the med

37. Safe Storage All medications are kept in a locked cabinet or lock box
Med keys are available only to persons who are authorized to administer medications
Refrigeration between 36-46oF may be needed for some medications

38. Asthma
Use the ASTHMA CARE PLAN form, not the usual Authorization for Med Admin form for asthma meds
The CARE PLAN provides more info on student’s individual asthma characteristics and needs
It provides the legal “Emergency Care Plan” for changing conditions that the other form does not
It helps in student and family asthma education

39. Asthma medication delivery
Inhalers
Mouthpiece and cap are to be washed in warm soapy water and thoroughly dried regularly
Use spacers if available, they deliver medication to the lungs very well
Read the instructions that come with spacers, if available.

40. Inhaler use Remove mouthpiece cover
Shake inhaler well for 2 to 5 seconds
Place inhaler in mouth
Take a deep breath and exhale completely
Inhale slowly and deeply through mouth while depressing the medication canister fully
Hold breath for 10 seconds
Wait 1 minute between puffs

41. Procedures
Contact your school nurse if a parent requests a Specialized Physical Health Care Procedure, as there are different authorization and training requirements
SPHCs
Nebulizer machine use for asthma meds
EpiPens
Diabetes meds and care
Catheterization
Gastrostomy feedings

42. Eye and ear medications
Always use gloves
If there is discharge, clean around each eye or ear with separate pieces of clean moist gauze
Have the student lie down
Be sure to use the correct eye or ear if the medicine is not prescribed for both
Practice good hand washing afterward

43. Eye drops
Using one hand gently pull down on the lower eye lid forming a small pouch
Hold the dropper about 1 inch above the lower lid pouch with the other hand
Drop the prescribed number of drops one at a time
Ask the student to rest with eyes closed for a minute and avoid rubbing eyes
Give them a kleenex to wipe excess moisture

44. Eye Ointment
Hold the nozzle of the tube approximately ½ to 1 inch above the eye
Apply a line of ointment to the inner edge of the lower eyelid
Start at the nose edge and move outward
Have student keep eye closed a minute and avoid rubbing eyes

45. Ear drops Cleanse away any discharge
Warm the ear drops in the palms of hands; never use hot water or microwave
Shake the container gently
Have the student lie down with the affected ear up or sit and tilt the head to the side
Do not allow the dropper to touch the ear
Pull the ear backward and upward (older child and adult) or back and down (under age 3) to open the ear canal
Put in prescribed number of drops
Keep the student still at least five minutes or, if prescribed, place a clean piece of cotton gently into the child’s ear

46. Disposing of Medications
Send home unused meds with the parent
Don’t flush meds down the toilet; 80% of our streams contain drugs that contaminate our water supply
gives info on proper disposal

47. File Medication Records
In the health cums
At the end of the year
If a student leaves the school
When the med is discontinued

48. Confidentiality
Only parent/guardian and authorized school staff should have access
Parent/guardian authorization is required for release of information

49. You are almost done
Print out and complete the Medication Administration Training for School Personnel Quiz
When finished, let your site school nurse know so she can meet with you to review the Quiz and answer any questions