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Medication Administration Annual Review

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Medication Errors Accidents Happen Report medication errors immediately to district nurse and building administrator Nurse will contact parent Complete Accident ... – PowerPoint PPT presentation

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Title: Medication Administration Annual Review


1
Medication Administration


Annual Review
  • A Training for School Personnel February 2007
  • Revised June 2008

Exit
Begin
2
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
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
    339.867 to 339.870 and OAR 581-021-0037.
  • Next Back

Exit
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.

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Next
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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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Next
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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

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Next
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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

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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

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Next
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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
  • 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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Next
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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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Next
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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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Next
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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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Next
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25
Five Rights
  • Right student
  • Always ask the students name
  • Right medication
  • Check the label
  • Right dose
  • Check the label
  • 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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Next
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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

Exit
Next
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28
Safe Storage and Handling
  • Refrigeration is necessary for some medications
  • Many liquid medications need to be shaken well
  • Beginning 2008-2009 refrigerated meds need to be
    locked
  • District will provide lock boxes

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Next
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29
Handling Medications
  • Always wash your hands
  • Avoid touching medication
  • Wear gloves if placing medication in students
    mouth

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Next
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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

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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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Next
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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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Next
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36
Student Does Not Come at Scheduled Time
  • Send for Student
  • Document
  • Notify
  • Teacher
  • Parent
  • Nurse

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Next
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37
Student Refuses Medication
  • Encourage
  • Document
  • Notify
  • Parent
  • Nurse

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Next
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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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Next
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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

Exit
Next
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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

Exit
Next
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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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Next
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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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Next
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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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Next
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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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Next
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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 students 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
  • Nurses responsibility is to provide proper
    training
  • Your responsibility is to follow the instruction

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Next
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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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Next
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53
Medication AdministrationQuiz
Begin
Exit
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.
  • Next question

Exit
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
  • Back

Exit
57
Question 2
  • If a parent calls saying the doctor has increased
    the dose from one pill to two, always follow the
    parents instructions.
  • True
  • False

Exit
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.
  • Back

Exit
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.
  • Next question

Exit
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

Exit
61
Incorrect
  • Oregon law states yearly instruction must be
    provided to designated school staff on the
    administration of medication.
  • Back

Exit
62
Correct
  • Oregon law states yearly instruction must be
    provided to designated school staff on the
    administration of medication.
  • Next question

Exit
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

Exit
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
  • Next question

Exit
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
  • Back

Exit
66
Question 5
  • Alcohol-based cough syrup can be given at school
    with written permission from a parent
  • True
  • False

Exit
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
  • Back

Exit
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.
  • Next question

Exit
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

Exit
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
  • Next question

Exit
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
  • Back

Exit
72
Question 7
  • When a parent asks you to give their child two
    Childrens Tylenol for a headache, it is OK to do
    so if you have the medicine.
  • True
  • False

Exit
73
Correct
  • Oregon law requires written permission and
    instruction from the students parent to
    administer non-prescription medication
  • It is the parents responsibility to provide a
    students medication
  • Next question

Exit
74
Incorrect
  • Oregon law requires written permission and
    instruction from the students parent to
    administer non-prescription medication
  • It is the parents responsibility to provide a
    students medication
  • Back

Exit
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

Exit
76
Incorrect
  • Law states school staff designated to administer
    medication must receive yearly training
  • Back

Exit
77
Correct
  • Law states school staff designated to administer
    medication must receive yearly training
  • Next question

Exit
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

Exit
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
  • Back

Exit
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
  • Next question

Exit
81
Question 10
  • Students may carry and self-administer cough
    drops as long as their parent sends them with the
    student
  • True
  • False

Exit
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
  • Next question

Exit
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
  • Back

Exit
84
Question 11
  • All medication should be stored in a clean,
    locked cabinet.
  • True
  • False

Exit
85
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
86
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
87
Question 12
  • If a student vomits after taking their
    medication, be sure to send a note home to the
    parent.
  • True
  • False

Exit
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
  • Back

Exit
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

Exit
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

Exit
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
  • Back

Exit
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
  • Next question

Exit
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

Exit
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.
  • Back

Exit
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.
  • Next question

Exit
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

Exit
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 1-800-222-1222.
  • Back

Exit
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 1-800-222-1222
  • Next question

Exit
99
Question 16
  • Teachers should know when their students are
    taking medication, in spite of confidentiality
    laws.
  • True
  • False

Exit
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
  • Next question

Exit
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
  • Back

Exit
102
Question 17
  • Always use pencil when recording medications so
    that you can make changes if a mistake is made.
  • True
  • False

Exit
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
  • Back

Exit
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
  • Next question

Exit
105
Question 18
  • At the end of the year, send all of the
    medication logs to Health Services at the DO.
  • True
  • False

Exit
106
Correct
  • Send completed Medication Logs to the DO
  • If the medication is complete
  • The student moves
  • At the end of the school year
  • Next question

Exit
107
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
108
Question 19
  • When the prescription label says to give the
    medicine at 1200 and lunch is at 1145, it is OK
    to give before lunch.
  • True
  • False

Exit
109
Correct
  • Medication is to be given within ½ hour before or
    after the designated time
  • Next question

Exit
110
Incorrect
  • Medication is to be given within ½ hour before or
    after the designated time
  • Back

Exit
111
Question 20
  • The 5 Rights of Medication Administration
    include
  • Right Student
  • Right Medication
  • Right Dose
  • Right Time
  • Right Route
  • True
  • False

Exit
112
Correct
  • If the person administering the medication always
    follows the 5 Rights, it is unlikely an error
    will occur.

Next
Exit
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
  • Back

Exit
114
References
  • Oregon Department of Education.
    www.ode.state.or.us/groups/supportstaff/hklb/schoo
    lnurses/medicationadmin.pdf Accessed April
    21,2007.
  • Oregon Administrative Rules, Chapter
    581-021-0037. Administration of Prescription and
    Nonprescription Medication to Students (2005).
  • Oregon Revised Statutes, Chapter 339.869
    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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