Medication Administration

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Medication Administration

• A Training for School Personnel January 2008

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Welcome to LCSD 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 the district nurse.Please
read all of the information and complete the
quiz. Following the quiz, there is a page to
submit me an email. I will send you a a course
evaluation. This information will help me to
improve this course. Make sure your name, job
description, and building is filled out 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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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
  339.867 to 339.870
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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

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The Law

• Administrative rules were adopted by the Oregon
  Department of Education in 1997, and amended by
  the legislature in 2004
• School districts must adopt policies and
  procedures for this rule including policies which
  address student self medication.

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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

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Three Types

• Prescription medication
• Non-prescription medication
• Student self-administered medications

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Prescription Medications

• Requires school personnel to be responsible only
  for prescription medication scheduled to be given
  during school hours, or non-prescription
  medications necessary for the child to remain in
  school.

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Prescription Medication

• Does not include injectable drugs
• Must be prepared and labeled by pharmacists and
  be in the original pharmacy container

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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 HE-26)
• New medication permission form must be completed
  each year
• Administered only if required during school hours

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These People Can Write Orders

• Doctor of medicine or osteopathy
• Physician assistant
• Nurse practitioner
• Dentist
• Optometrist

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Non-Prescription or Over-the-Counter Medication

• Commercially prepared
• Original container
• Non-alcohol based
• Necessary for student to remain in school

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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

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Student Self-Medication

• Requires no assistance
• Requires no documentation that medication was
  taken
• Grades K-8 Self-medication of prescription and
  nonprescription medication is not allowed except
  in cases where a student must carry such
  medication on his/her person or there is a MD
  order.
• Policy states that with grades 9-12 paperwork
  needs to be completed for prescriptive and
  nonprescription medications (HE-26 HE-28)
• Cannot self-medicate Narcotics, Stimulants, or
  Barbiturates

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Remember!Original Container

• NO Baggies
• NO Envelopes
• NO Medication Boxes

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Routes of Medication

• Oral
• Tablets, capsules, elixirs or suspensions
• Topical
• Skin, eyes, ears, nose
• Inhaled
• Mouth or nose

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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 (OR-OSHS 1910.1030 (2) ix x)

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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

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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

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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

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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

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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

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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 9-1-1

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Five Rights

• Right student
• Right medication
• Right dose
• Right time
• Right route

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Handling Medications

• Always wash your hands
• Avoid touching medication
• Wear gloves if placing medication in students
  mouth

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Safe Storage and
Handling

• Store all medication in original containers in
  secure place
• NEVER administer medications from an unlabeled
  container

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Safe Storage and Handling

• Store medications in a clean, locked cabinet
• Narcotics, stimulants, and barbiturates should be
  counted upon arrival at school (May be counted
  with parent or trained school staff. HE-25)

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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

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Safe Storage and Handling

• Refrigeration is necessary for some medications
• Many liquid medications need to be shaken well

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Disposal of Medication

• Notify parent of unused medication
• Any unclaimed medication should be disposed of in
  the toilet or regulated waste container in the
  presence of two staff members
• Note parent contact and medication disposal on
  medication log (HE-20)

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Handling The 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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Student Does Not Come at Scheduled Time

• Send for Student
• Document
• Notify
• Teacher
• Parent
• Nurse

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Student Refuses Medication

• Encourage
• Document
• Notify
• Parent
• Nurse

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Student Vomits Or Spits Out Medication

• Document
• Notify
• Parent
• Check for symptoms of illness
• Fever
• Stomachache
• Headache

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Field Trips and Off- Campus
Activities

• Staff person trained in medication administration
  must accompany group if medications will be
  required-PLAN AHEAD!
• Keep in original container
• Sign medication out, then in to the assigned
  staff person
• Document administration on return
• Recommend notifying nurse two weeks prior to trip
  if medication training is necessary

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Field Trip Supplies

• Medication Log (HE-20)
• Medication in original container
• Hand cleaner
• Drinking water
• Safe container to transport

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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 school nurse and parent

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Medication Errors

• Accidents Happen
• Report medication errors immediately to school
  nurse and building administrator
• Complete Incident Report

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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

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Remember!

• Once LCSD 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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Record Keeping

• Legal document
• Use ink
• Students full name and DOB(as in SM)
• Medication Permission Form (HE-26)
• Medication Log (HE-20)
• Sign initials in log immediately after
  administering medication

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Record Keeping

• Only one student and one medication 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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Retaining Medication Records

• Send completed forms to the District Nurse
• 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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Confidentiality

• Student medication files are CONFIDENTIAL
• Access limited to school staff with a need to
  know and parents
• Parent/Guardian authorization is required for
  release of information

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Parent Communication

• Avenues of communication to parents
• school newsletters
• informational packets
• registration packet
• student handbooks

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Dealing with Concerned Parent

• Validate parent emotions
• Share written information
• Include school nurse and administrator
• Set boundaries and ensure your own safety

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Benefits for Parents

• Trained staff will assist student
• Clear, concise, accurate documentation is
  available for the parent/guardian, physician,
  nurse, and other authorized reviews
• Only parent permission required for
  non-prescription medication

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Establishing a Cooperative School Environment

• Success requires a team effort
• Include teacher in planning students medication
  needs

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Staff Protection

• School staff are protected by careful observation
  of regulations of the medication law, rules,
  district policy
• Nurses responsibility is to provide proper
  training
• Your responsibility is to follow the instruction

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If you have any questions or concerns call a
nurse before giving the medication
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