516 STUDENT MEDICATION
I. PURPOSE
The purpose of this policy is to set forth the provisions that must be followed when administering nonemergency prescription medication to students at school.
II. GENERAL STATEMENT OF POLICY
The school district acknowledges that some students may require prescribed drugs or medication during the school day. The school district’s licensed school nurse, trained health clerk, principal, or teacher will administer prescribed medications in accordance with law and school district procedures.
III. REQUIREMENTS - Student Medication
Independent School District #518 Board of Education recognizes that diagnoisis and treatment of illness, prescribing of medications, treatments, or home remedies are not the responsibility of the school district. The Board of Education also recognizes that the primary responsibility of medications/treatment administration lies with the parent and not with the school district. However, there are instances where it becomes necessary for medications to be administered in the school ISD #518 Board of Education desires to maintain safe medication management and administration practices for its students according to the current standards of care and legislative requirements.
Therefore, Medications may be administered in the school when the student requires the medication for life sustaining purposes, the student’s health may be jeopardized without it, or when it is needed to promote the health of the student so that learning is enhanced. A licensed school nurse, or a public or private health organization or other appropriate party (if appropriately contracted by the school district under MN Stat. 121A.21) shall develop protocols for the management and procedures for the administration of medications in the school setting. These protocols and procedures shall set forth the requirements for medication administration to students at school. The school district administrator who supervises school health services shall submit these protocols and procedures necessary to implement this policy to the board for approval. Upon approval by the school board, such protocols and guidelines shall be an addendum to this policy.
Medications and treatments that must be administered during school hours shall be administered by the licensed school nurse or by a designee who the school nurse has trained and delegated the task of medication/treatment administration. Exceptions include those circumstances in which current Minnesota Statutes specify that students may carry and self administer medication in the school. The school health office shall be notified in writing when medication must be administered during school hours. A completed school medication authorization form, with a licensed prescriber’s signature for prescription medication, is required for all medication and treatments administered by school personnel and by students who meet the requirements to self-carry, self-administer medications during school hours annually &/or when administration requirements change.
Legal References: Minn. Stat. § 13.32 (Student Health Data)
Minn. Stat. § 121A.21 (Hiring of Health Personnel)
Minn. Stat. § 121A.22 (Administration of Drugs and Medicine)
Minn. Stat. § 121A.221 (Possession and Use of Asthma Inhalers by Asthmatic Students)
Minn. Stat. § 121A.2205 (Possession and Use of Nonsyringe Injectors of Epinephrine; Model Policy)
Minn. Stat. 121A.222 (Nonprescription Pain Relievers by Secondary Students)
Minn. Stat. § 151.212 (Label of Prescription Drug Containers)
20 U.S.C. 1400, et seq. (IDEA)
29 U.S.C. 794, et seq. (Section 504)
Cross References: MSBA/MASA Model Policy 418 (Drug-Free Workplace/Drug-Free School)
First Reading: 10/18/05
Second Reading: 11/15/05
Adopted: 11/15/05
MEDICATION ADMINISTRATION PROTOCOL
Worthington Independent School District 518
Safe Medication Administration is a Top Priority:
A. Safety Rules
a. The primary responsibility of medication/treatment (from here-on known as medication) administration lies with the student’s parent or guardian. If a medication can be administered at home – this is always the best choice.
b. Never leave medications unattended. Always lock up medication each and every time you leave the health office or medication storage area.
c. ISD #518 “Consent for Medication Administration” form(s) must be completed before any medication administration can begin. Prescription medications ALWAYS require the signature of a licensed prescriber along with a parent/guardian’s written permission before the student will be administered the medication at school.
i. Examples of prescription medication include: antibiotics, inhalers, insulin, some pain medications, some cough medications, some medications for migraine headaches, medication for nebulizer treatments, etc. If you are not sure if a medication requires a prescription, consult with the school nurse, pharmacist, or the drug reference book.
d. Medication that can be purchased without a physician’s prescription (Over-the-Counter) may be administered to students with parental permission. A physician’s signature may be requested at the discretion of the licensed school nurse.
e. Medications in which the FDA (Food and Drug Administration) has not established safe and effective dosing parameters for children 18 & under will not be administered in the school (i.e. vitamins, herbal remedies, or homeopathic remedies).
f. Parents/Guardians will be required to meet with the school nurse before narcotic medications prescribed for pain or cough will be administered to students.
g. School personnel may refuse to administer ANY medication if the medication procedure is not followed or if there is any question about the medication or its administration procedure. An attempt may be made to contact the parent or guardian if the medication is not administered. The school nurse may request to receive further information about the prescription, if needed, prior to administration of any substance.
i. Reasons may include: dose exceeds manufacturer’s recommendation, expired date, medication is not in a properly labeled container, medication label cannot be read by health office staff (foreign language), etc.
h. Medication must arrive to the health office in the original manufacturer’s unopened container (over-the-counter medications), or in a properly labeled pharmacy container (prescription medications). Pharmacy labeled containers must include the following:
i. The student’s name
ii. The pharmacy name, address, and phone number
iii. The name of the medication and the dosage
iv. The physician’s name
v. The date the prescription was filled
Medication that arrives in a white envelope, plastic bag, etc. will not be accepted. School health personnel will not administer any medication that does not appear to be in its original container.
i. The parent or guardian must pick up all unused controlled substance and/or psychotropic medication – it will not be sent home with the student. All medication not picked up within one week of the last day of school will be destroyed by school personnel.
j. ISD #518 Consent for Medication Administration forms are needed:
i. Annually or at the start of any new medication;
ii. When there is a change in medication (i.e., dose, time, medication, etc.); or
iii. At the discretion of the licensed school nurse
k. Medications may be discontinued or put on hold by either parent/guardian or physician at any time. The school health office must be notified in writing when a medication is discontinued or held.
l. Controlled substance & psychotropic medications must be counted when received into the health office. Students will not be allowed to self-carry & self-administer controlled substance &/or psychotropic medications.
m. The Licensed School Nurse may take a verbal/phone medication authorization from a licensed prescriber for prescription medication or from a parent for over-the-counter medications as long as the verbal authorization is followed by with a written consent the next school day. Fax transmissions with confidentiality safeguards in place are acceptable. Unlicensed personnel SHOULD NOT under any circumstances take verbal/phone orders from physicians, licensed prescribers, or parents.
n. Prescription medications are not to be carried by the student, but will be left with the school health office. Exceptions to this requirement are those circumstances in which current MN Statues specify that students may carry and self-administer medication in the school, and medication administered as noted in a written agreement between the school district and the parent or as specified in an IEP (individualized education plan), Section 504 plan, or IHP (individual health plan)
Set Up Procedure:
A. To insure safety always double check the label on the medication bottle, and the physician’s order &/or the parent’s permission form when setting up and administering medications to students.
a. Daily Oral Medications
i. Once weekly, set-up student’s medications using the student’s pill minder in the student’s individual medication bin. Be sure to fill only one student pill minder at a time. Avoid medication/hand contact and fill the pill minder directly from the prescription bottle. Students who have medications that are administered in large quantities, i.e. enzyme capsules for Cystic Fibrosis, may have their medications set-up in small plastic medication cups daily at time of administration.
b. As Needed Medication or PRN’s
i. Over-the –Counter medications are to be kept in their original container until administered to the student. The container should be new and unopened when brought to the health office. Label the medication container with the student’s name and grade or date of birth. Families who have more than one student in the same school building may provide one container of OTC medication/family. The manufacturer’s recommended dose requirements, as printed on the label, will be followed when administering OTC medications to students. If the parent requests a dose that exceeds the manufacturer’s recommended dose, a physician’s signature will be required before the dose will be administered.
c. Other Medication
i. Insulin: A student’s insulin will be kept with their diabetic testing supplies in a locked storage area in the health office unless other arrangements have been made in advance with the school nurse in cooperation with the parent, student, & school district. Refer to the student’s Individual Health Plan, IEP, 504 plan &/or and medication consent form regarding insulin set-up and administration. Proper disposal for sharps related to the needs of the diabetic will be available.
ii. Nebulized Medication: Nebulized medications and equipment will be kept in a locked area in the health office. Students who require nebulized treatments during the school day will have the treatments in the health office unless other arrangements are made in advance with the school nurse in cooperation with the parent and teacher.
iii. Inhalers and Epi-pens: If requested by the parent and deemed appropriate according to MN Statutes, students who require the use of inhaler medications and/or Epi-pens (emergency medications for severe allergic reactions) may carry their own medications on their person as long as the following requirements are met: 1.) completed Consent for Medication Administration form with written parental and physician permission, renewed yearly, 2.) proper labeling, 3.) an assessment by the school nurse to insure that the student possesses the proper knowledge and skills to safely posses and use the medication appropriately.
Administration and Documentation of Medication Administration:
A. Administration
a. No one is allowed to administer medications unless they have been trained in medication administration and delegated this task by the licensed school nurse. Training should be done on an annual basis.
b. Have the student get their cup of water, if appropriate.
c. Ask the student to state their name and their teacher’s name or some other statement of identity (i.e. birthdate), a picture of the student may be placed with the student’s medication log or near their medication bin if helpful for student identification. Once the student is correctly identified, the medication may be administered.
d. The school health personnel should always be the one to handle the medication container, not the student. Put the medication directly into the student’s hand from the pill minder. Administer the medication from the student’s pill minder and not from the student’s medication bottle.
e. Insure that the student has swallowed the medication.
B. Documentation
a. Document the medication administration on the student’s individual medication log after each administration.
b. When all medications have been given for a specific time, i.e. AM meds or Noon meds, health office staff may leave a note or card stating that all meds have been given to avoid duplication of administration.
c. If a student’s medication was missed, document why, i.e. absent, ill, called – did not show, refused, etc. Contact the parent and complete an injury/incident report form if a medication was administered incorrectly (i.e., wrong time, wrong dose, wrong med, wrong student, etc).
d. Acceptable timetable for the administration of regularly scheduled medications is ½ hour before or after the prescribed time for life sustaining medications, i.e. seizure and diabetic medications, and 30 minutes before or 45 minutes after for life altering medications, i.e. focused attention medications and antibiotics. Late students should be called to the health office. If lateness becomes a frequent problem, consult with the licensed school nurse, case manager, and/or teacher regarding a solution. If a medication is given outside the allotted time, document the time that the medication was administered, notify the parent or guardian, and complete an injury/incident report form.
e. In the event of a field trip or other out-of-school event, the licensed school nurse or principal may designate a staff member to administer the medication to the student. After proper training in medication administration procedures by the licensed school nurse the designee may administer the medication.
f. The “Five Rights” of medication will be followed at all times; right student, right medication, right time, right dosage, and right documentation.
When to Notify the School Nurse:
A. Any time there is a new prescription medication, or any change in a current medication, i.e. the medication itself, dosage, time, prescriber, or discontinuation of a medication.
B. Any time there is an adverse reaction to a medication or a question regarding a medication or its administration (complete incident/injury report form).
C. Any time there is a medication error, including errors of omission (complete incident/injury report form).
D. Any time an “as needed” or prn pain medication is taken more than two times in one week for two weeks or more, or other unusual patterns.
E. When the controlled substance count is not correct (complete incident/injury report form).
5/22/02 KL
Rev. 10/2005 KL
Worthington Middle School, Senior High School and Alternative Learning Center
PARENT AUTHORIZATION FORM
OVER-THE-COUNTER PAIN RELIEF POSSESION FOR SECONDARY STUDENTS
A new law was passed in Minnesota August 1, 2005 (Statute 121A.222) which allows secondary students (grades 7-12) to possess and appropriately use over-the-counter pain medication (such as Acetaminophen [Tylenol] or Ibuprofen [Motrin]) with annual written parent permission. This does not include cold & allergy medications that contain ephedrine or pseudo ephedrine (such as Sudafed).
Being the parent/guardian of _________________________, grade ____ here-by give my permission for him/her to possess and appropriately use the following over-the-counter pain medication ________________________ in a manner consistent with the products label during the current school year.
I understand that if the above named student is found to be in violation of the law requirements by [but not limited to] inappropriately using the medication (such as not following the manufacturer’s recommended instructions for use including correct dose recommendations) or sharing his/her medication with another student or staff member, their right to posses and carry over-the-counter pain medication may be terminated by the school district.
I further understand that students found to be in possession of over-the-counter pain relief medication prior to their parent completing & giving this form to the high school health office could be considered a violation of the law, and therefore could terminate their rights according to the law.
_____________________________ _____________________
Parent/Guardian Signature Date of Signature
For the Student:
I have read this authorization form and agree to follow all the rules that apply to the right & privilege of possessing and self-administering an over-the-counter pain relief medication.
_____________________________ _____________________
Student Signature Date of Signature
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Office use only:
Date received by Health Office Staff ______________ Initials ________ 9/2005 kl
ISD #518 Worthington
Consent for Medication Administration
Medication administration should be arranged outside of school hours if at all possible.
ALL PRESCRIPTION MEDICATION REQUIRES A PHYSICIAN’S SIGNATURE.
Student: _______________________________ Date of Birth: ____________ Grade: _____
School: [ ] Prairie, [ ] Middle, [ ] Sr. High School Year: _____________________
Parent/Guardian Name: ________________________Phone: (H) ____________(W)_____________
1. Reason for medication/treatment: ______________________________
2. Name of Medication ____________________________________Dosage: _____________________
( ) tablet/capsule ( ) liquid ( ) inhaler ( ) nebulizer ( ) other
3. Time Medication is to be given AT SCHOOL: ( ) with lunch ( ) other___________
4. Start Date: ____________Stop date:_________, ( ) end of school year, ( ) until further notice
from parent or M.D.
5. Restrictions and/or side effects: ___________________________________ ( ) non anticipated
6. For student’s with more than once daily dosing: If the morning dose usually taken at home is missed, this dose may be administered at school by school personnel. PARENT/GUARDIAN is required to notify school of missed dose at home.
I authorize school personnel to set-up and administer the above medication to my child (unless self administration/self carry has been indicated). I understand that the medication must be provided in a pharmacy or unopened manufacturer’s labeled bottle. Medication in plastic bags or white envelopes WILL NOT be accepted.
I give my permission for my child’s medical office to fax this form to my child’s school.
Parent/Guardian Signature Date