Excelling Teaching & Learning : School Health Services : School Medication

The following is SUSD's policy on medication administration in the schools. Interested readers are also referred to the current edition of SUSD's "Uniform Code of Student Conduct" and Governing Board Policies JLCD and JLCD-R.

MEDICATION ADMINISTRATION

The safe and effective use of medications for the treatment of illness and disability has enabled many children to attend school… The use of medications by students has increased dramatically over the last few years*.

RATIONALE

There are circumstances when it is necessary to administer medication to a student during school hours. This may enable the student to attend school, improve or maintain their health status and/or improve their potential for learning.

The school nurse provides direct care to many students with illnesses or disabilities that are treated with medication. She is the health professional on campus educated in medication administration including administration techniques, indications, contraindications and side effects.

MANDATORY ACTIVITIES

1. The school nurse will:
   1. administer medication according to SUSD Board and School Health policies, School Nurse Standards of Practice, the Arizona Nurse Practice Act and Arizona law regarding administration of medication.
   2. maintain current knowledge of the effective use of drugs and treatments used by the school aged child and the possible side effects.
   3. possess the abilities to properly administer medication and perform treatments in the school setting, to monitor potential side effects and to properly document such.
       
2. The school principal shall designate school staff to administer appropriate medication in the absence of the school nurse or qualified nurse substitute.
   
   The school nurse will train the designees in basic medication administration. This training will include safety and administration procedures and what to do in case of a medication error. Documentation of the training will be maintained by the Principal and the nurse.

All Medications

1. All medication administered by school personnel must be approved by the U.S. Food and Drug Administration (FDA). Information on dosage, side effects and contraindications of any medication or medicinal like substance given by school personnel must be readily available from a professionally acknowledged resource (Physician's Desk Reference or other U.S. published drug reference book, FDA or USP website, etc).
    
2. All medication shall be kept in secured storage in the Health Center with the exception of emergency medications that may be carried by a student with special written request of the physician, parent/guardian and student. (See "Special Consent to Carry Medication" below.)
   
   It is recognized that the nurse may not be aware of students who have medication in their possession. In such situations District disciplinary procedures will be followed by site administration.
    
3. Before the end of the school year, the parent or legal guardian will be notified to pick up any left over personal medication from the Health Center. Medications not returned to the family will be discarded in an appropriate and legal manner.

Prescription Medications

1. No student will be given prescription medication except upon order from a U.S. licensed physician, nurse practitioner, physician assistant or dentist who has the responsibility for medical management of the student.
    
2. Prescription medication must be in the original container with a pharmacy label listing the student's name, medication name, dosage and the prescriber's name. (Prescriber's phone number must be on the label or on file in the Health Center.)
   
   The prescription container shall serve as the prescriber's original order since the prescription is on file at the pharmacy. A written order from the prescriber must accompany any change in medication dosage.
   
   No medication from another country will be given.
   
   No sample medication will be given unless accompanied by a written note from the prescribing physician/healthcare provider.
    
3. Administration of the medication during the school day must be medically necessary. The school nurse will determine the schedule for medication administration unless specified by the prescriber.
    
4. Written parent/guardian request and consent is required (Form HMES-503 "Parent Request for Administration of Medication"). Parent/guardian consent shall be renewed annually. The parent/guardian assumes full responsibility for the supply, appropriate transportation and maintenance of prescription medication.
    
5. When medication is delivered to the school, the nurse or principal's designee will note the amount of medication received and document on the medication administration record.
    
6. All medication administration will be documented by the school nurse (or principal's designee) on the medication administration record. The signature of the person administering the medication must appear on the sheet. At the end of the school year, or when the prescription is completed, the medication administration record will be placed in the student's health file.
    
7. Reasonable efforts will be made to ensure that the student receives his/her medication. If a student persistently skips medication doses, the parent will be notified. The school nurse and school staff are encouraged to work with the student and family to solve problems of non-compliance.
    
8. Reconciliation of the supply of all prescription medication will be made at least monthly and documented on the medication administration record. The school principal and District Health Services Coordinator shall be notified immediately if the medication count is off.
    
9. If a medication error occurs, the individual who made the error will do an incident report following District Risk Management protocol. If a medication cabinet is broken into resulting in stolen medications, the police shall be notified immediately. Notification shall be sent to the parent/guardian with a request to replenish supplies.

Special Consent to Carry and Self-Administer Medication

1. In cases of life-saving medication where time is of the essence, particularly asthma inhalers and Epi-pen (self-injectable epinephrine), students may be allowed to carry and self-administer such medication on school grounds and/or at school functions.
    
2. Such situations require a release form signed by the healthcare provider, the parent/guardian and the student.
    
3. If the school nurse has doubts or questions as to the maturity and capability of the student to appropriately carry and self-administer a medication, the concerns should be expressed to the principal and parent. The concerns, conversations and responses should be documented.
    
4. The above policy shall not be interpreted to allow a student to carry any medication a physician and parent should decide upon. This policy gives authorization for life saving/emergency medication only.

Non-prescription/Over-the-Counter Medications

MEDICATION ADMINISTRATION TO EMPLOYEES

1. At the discretion of the school nurse and building principal, appropriate OTC medication may be available to employees.
    
2. The school nurse will not administer allergy shots or other non-emergency injectable medication to employees.

_________________________________________________________________________________________________________
* National Association of School Nurses, Position Statement, "Medication Administration in the School Setting", adopted 1993, revised 1997.