MEDICATION ADMINISTRATION - Oregon · MEDICATION ADMINISTRATION A Training for School Personnel Updated 2016 A special thanks to MESD for their expertise in developing this PowerPoint

MEDICATION

ADMINISTRATION

A Training for School Personnel

Updated 2016 A special thanks to MESD for their expertise in developing this PowerPoint

and keeping it updated with current regulations.

1

THE LAW

• ORS 339.867-339.870 & OAR 581-021-0037

• Designated school personnel are required to receive ODE approved training

• Districts may not require school personnel to administer medications without appropriate training

• Non-injectable medications

• Districts must adopt policies/procedures for self-administration

• General Intent

2

The Law (continued)

• Designated School Personnel

• Identified by school administrator

• Best to have one point person with a backup in case of absence

• Must have procedures for handling field trips

(including overnight trips) and other events that

occur outside the usual school setting

3

The Law (continued)

• The definition of physician includes these people licensed by the respective licensing board in the State of Oregon:

Doctor of Medicine or Osteopathy (MD/DO)

Physician Assistant

Nurse Practitioner

Dentist

Optometrist

Naturopathic Physician

4

DISTRICT POLICIES &

PROCEDURES

• Each school district shall adopt policies and procedures that

provide for:

• Administration of prescription and non-prescription to students

by trained staff;

• Student self-medication including age appropriate guidelines and

permit self-medication;

• Permit designated staff to administer non-prescription

medication under the written permission and instruction from

parent.

5

District Policies And Procedures

(continued)

• Must include a process to designate, train and supervise

appropriate staff that takes into account when a student is in

school, at a school sponsored activity, under the supervision of

school personnel, in before-school or after-school care

programs on school-owned property, and in transit to or from

school or school-sponsored activities.

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NON-PRESCRIPTION

MEDICATIONS

• Must be commercially prepared, FDA approved and non-

alcohol based.

• Parent’s must have signed written permission, and the dose

must be consistent with the manufacturer’s guideline.

• Must be necessary for student to remain in school.

• Must be in original container.

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PRESCRIPTION MEDICATIONS

• Must be prepared and labeled by a registered U.S. pharmacist,

and in the original bottle.

• Requires written instructions from an Oregon licensed

practitioner. A prescription label meets this requirement.

• Requires written permission from parent.

• Verbal orders/out of state orders can only be taken by the

registered nurse.

• Only if required during school hours

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THE SIX RIGHTS

• Right Student

• Right Medication

• Right Dose

• Right Time

• Right Method of Administering the Medicine

• Right Documentation

These must all be right before any medicine is administered

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RIGHT TIME

• Parent written authorization for any medication must include a

time for the medication to be given.

• Ideally the medication is to be administered at the time

specified. However, medicine may be given up to 30 minutes

before or after time specified and still be the Right Time

10

HANDLING MEDICATIONS

• Obtain water from a clean source, not from the first aid

dedicated sink.

• Always wash hands prior to medication administration.

• Avoid touching the medication.

• Wear gloves if placing medication in student’s mouth.

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Handling Medications (continued)

• Tablets requiring cutting should be cut by the parent and placed in the

medicine container that is delivered to school.

• Parents must provide pill crusher if student’s medication needs

crushing before giving.

• Parent must provide a calibrated measuring device for measuring liquid

medication.

12

MEDICATION

ADMINISTRATION METHODS

• Oral (by mouth)

Tablets

Capsules

Syrup, Elixir, Suspension

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Medication Administration Methods

(continued)

• Topical

Skin

Eyes

Ears

Nose

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Medication Administration Methods

(continued)

• Administering medicine rectally, by nebulizer or intranasal are

not discussed in this class.

• If a student requires medication by these methods, your school

nurse will initiate an individualized procedure and train

appropriate staff.

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Medication Administration Methods

(continued)

• Inhalers

Nasal

Oral

Each Metered Dose Inhaler (MDI) has different use and

care, priming, shaking and cleaning directions.

Review insert instructions before use.

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SAFE STORAGE & HANDLING

• Store all medications in their original containers in a secure

locked place.

• Never administer medications from an unlabeled container.

• Never empty medication into a plastic bag or container.

• Never accept medication in a bag or unmarked container.

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Safe Storage And Handling

(continued)

• Certain medications require counting by two individuals upon

arrival at school. See your District policy.

• When refrigeration is required for the medication,

place in a dedicated space in the refrigerator and

in a sealed container.

• Discuss and make plan with administrator for

medication removal in the event of an emergency

evacuation.

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Safe Storage and Handling

(continued)

• All medications are to be brought to school and returned home

by the parent/guardian/designated adult.

• All changes in medication instructions must be made by the

parent in writing. We cannot accept a verbal request from a

parent.

• At the end of the school year parents are to pick up any unused

medicines.

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Safe Storage and Handling

(continued)

• To dispose of medications, remove from container, mix with

undesirable substance such as pencil shavings or used coffee

grounds, and place in impermeable plastic sealable bag, crush all

pills, open capsules and add water to mix and create an

undesirable substance. Discard in trash as close to pickup day

and time as possible.

• Student information should be removed or concealed with

marker before discarding bottle or container.

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Counting Pills

• Some pills require counting by 2 people

• Any controlled substance:

• Sedatives

• Stimulants

• Anti-convulsive

• Narcotic analgesics

• Pyschotropics

• May count with parent & staff or 2 staff members

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DOCUMENTATION

• Documentation must be accurate, legible and completed at the

time of the administration.

• Document in blue or black ink only. No pencil.

• If you make a mistake in charting, cross out with a single line

and mark “ME” (mistaken entry), do not use white out.

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Charting Forms

23

Charting Forms (continued)

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Charting Forms (continued)

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Charting Forms (continued)

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CONFIDENTIALITY

• Student medication files are confidential.

• Files should be locked with the medications

and access limited to authorized school staff.

• Parent written authorization is required for

release of information.

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MEDICATION RECORD

RETENTION

• Medication records should be filed at the end of the school

year. Place record in student’s health folder in the cumulative

file.

• If medication administration is related to an IEP, the

medication record is placed in the Special Education file for the

student.

28

MEDICATION ERRORS &

UNEXPECTED SITUATIONS

• Report medication errors immediately to the parent, building

administrator, and the school nurse.

• The following actions constitute an error:

Medication not given.

Medication administered to wrong student.

Wrong medication or wrong dose given to student.

Medication given at wrong time.

Medication given the wrong way or route.

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Medication Errors and Unexpected

Situations (continued)

• If student does not come for medication at scheduled time:

send for, document and notify parent.

• If student refuses medication: ask for reason, encourage,

document, notify parent and school nurse.

• If student vomits or spits out medication: document, notify

parent, send home if ill.

• All medication has the potential for side effects. Report any

unusual symptoms or behaviors to school nurse and parent

immediately.

30

STUDENT SELF-

ADMINISTRATION

• If a student is permitted to self-administer medications it means

no assistance and no documentation is necessary .

• To self-administer, the student must be able to demonstrate the

ability, both developmentally and behaviorally, to self medicate

with written permission from parent, and building

administrator, and physician if the medication is a prescription

medicine.

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Student Self-Administration

(continued)

• Check with your school district for a self-administration policy

and written agreement for all parties to sign.

• This agreement may be revoked at any time if student unable to

comply with agreement.

32

FIELD TRIPS OR OFF CAMPUS

ACTIVITIES

• If any medication is to be administered when students are on a

field trip or off campus , a staff person trained in medication

administration must accompany the student group.

• Any/all medications taken on the activity must

be kept in their original container.

• Trained staff will sign the medications out and

then back and document administration upon return to

school.

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Whole Child, Whole School, Whole

Community Approach to School Health

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QUESTIONS?

THANK YOU

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