Verbalize knowledge of laws and policies for administration of prescribed and over the counter medication to students.

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1 Medication Administration for Non-Licensed School Staff Canton City Schools School Health Issues: A federal mandate created in the 1970s obligated schools to provide children with medical services, including medication administration. Medications that schools are asked to manage may include controlled substances, emergency and psychotropic medications, and a range of therapeutic interventions for chronic illnesses such as diabetes and asthma. Purpose: The purpose of this program is to allow you to review the medication administration policy for Canton City Schools at your convenience. There is a post-test at the end. Print the test and answer the questions. Send the completed answer sheet to Health Services via the PONY. You will still need to be checked off on the administration of medication by the school nurse. Training Objectives: Verbalize knowledge of laws and policies for administration of prescribed and over the counter medication to students. Demonstrate understanding of proper administration & documentation of oral medications including asthma medications. Follow procedures when medications are delivered to the school by student or parent/ guardian. Demonstrate knowledge of handling and storage of all medications. Ohio Laws: Oral medication (both Prescribed and Over-The-Counter) administration is governed by Ohio Revised Code (ORC) The law authorizes school districts to implement policies and procedures so that students can receive oral medication at school. Asthma inhalers are considered oral medication.

2 Revised codes can be found at Liability Issues: Ohio Revised Code (E): No person who has been authorized by a board of education to administer a drug. Is liable in civil damages for administering the drug, unless such person acts in a manner that constitutes gross negligence or wanton or reckless misconduct ORC (B):School district employee is not liable in damages in a civil action for injury, death, loss to the person or property allegedly arising from a district employee s prohibiting / or permitting a student from using an inhaler because of the employee s good faith belief that the conditions of (not having parent & licensed prescribed authorization) had not been satisfied, nor allegedly arising from the use of the inhaler by a student for whom it was not prescribed What are Oral Medications? Oral medications are those taken by mouth. They need not be swallowed, but may be inhaled through the mouth. Oral medications can be in pill, tablet, capsule, liquid or powder form. CCS Medication Policy/Procedure: The Registered Nurse in the building may oversee giving oral medication to students. Licensed Health Care Provider & parent permission is required before medication will be administered. New authorization is needed each school year. Parents may come and administer medication. Medication must be in the original pharmacy labeled container. Student may carry an inhaler when the Self-Medication for Asthma Inhalers Authorization Form is completed and the School Nurse has evaluated the student s ability to properly use the inhaler.

3 What to do with medication and the containers when brought to school: Medication must come to school in the originally labeled container complete with student s name, medication name, dosage and time to be given. A responsible adult should bring medication to school when possible. All pills in bottle should be same color, shape & size. Tablets should be cut by parents before being brought to school when ½ tablet or pill is ordered. Medications are kept in a locked area at all times. Medication should be counted and recorded on the back of the medication log upon receiving medication at school. Any medication sent to school without Doctors Authorization form and Parent Authorization correctly completed must be sent back home until both forms are received and completed. Remember Never give medication without all written instructions and a properly labeled container. Never give medication if the written information does not match the labeled container. Contact your School Nurse if you have any questions prior to giving the medication. Medication Training: School staff who will be administering medications will be trained by a School Nurse for the initial training. The yearly review may be completed on line by viewing this power point and obtaining a minimum of 80% on the post test. Individuals who have not received training per CCS training protocol cannot administer medication.

4 The 5 Rights : Remember these five rights when administering medication to students. Right Student Right Medication Right Dosage Right Time Right Route Hand Washing: Hand washing is the single most important practice preventing transmission of infectious organisms. Hand washing should be encouraged often. It is also important to follow hand washing procedures before and after administering medication to the student. Dispensing oral medication: Read the medication label when picking up the container. Ask the student to state his/her name, review photo (if available). Read the label again and pour the pill into the cap of the medication bottle a paper cup or a medication cup. Pour liquid into a measuring device. Administer the medication. Close the container and read the label again before putting the container away. Stay with the student until you are sure the medication has been swallowed. Document the medication administration on the Medication Administration Log on the proper date with your initials.

5 Use of an Inhaler: Administration steps: student should: Remove mouthpiece cover Shake inhaler well for 2 to 5 seconds Place inhaler in mouth Take a deep breath and exhale completely Inhale slowly and deeply through mouth, depress medication canister fully Hold his/her breath for 10 seconds Wait one full minute between each puff given. Connect inhaler to spacer when ordered. Have student rinse mouth with water after using inhaler to prevent tooth decay. Pouring Liquid Medication: Identify student. Take medication out of locked cabinet. Hold bottle with label facing away from you. Pour medication at eye level into dispensing cup. Identify student again. Administer medication. Document medication administration on the Medication log. Administration of an Epi-Pen Pull off gray safety cap. 2. Place black tip on outer thigh. Stabilize the thigh. You may inject through clothing. 3. Press forcefully to active mechanism. Hold pen in place for 10 seconds.

6 4. Dispose of Epi-Pen as a contaminated sharp. 5. Massage the injection area for 10 seconds. NOTE: You must demonstrate this skill using the Epi-Pen Trainer to your School Nurse Medication Logs: Green Medication Logs are to be used for medications given daily. Blue Medication Logs are to be used for asthma inhalers or nebulizers only. Pink Medication Logs are to be used for as needed medications with the exception of asthma medications. Why Document? The medication log becomes a permanent record for parents and health providers, and provides legal protection to those who give medications at school. It helps prevent children from missing their medication. Documenting prevents the student from receiving a double-dose of the medication. Documenting: Place your initials and signature on the front of the proper log when giving a medication for the first time. Place your initials in the proper date box If giving an as needed medication also place the time the medication was given. You must verify what time the as needed medication (including inhalers) was given last. You may have to contact the parent or guardian if the student is requesting the medication when it is ordered every 2-12hours ad needed. For example if an inhaler is ordered every 3 hours as needed and the student request the inhaler at 9:00am you must verify with the parent that the inhaler has not been given since 6:00am. Documenting missed doses: All daily medications must be documented daily starting from the date the order and parent authorization is received.

7 If a medication is missed for any reason including snow days, days absent, or doses forgotten the proper code should be placed in the date box. The codes for missed medications can be found on the bottom of each medication log. Medication Error Reporting: Keep the student in the clinic. Assess student s status. Identify the incorrect dose or type of medication taken by the student. Office staff should immediately notify the School Nurse and Principal. The School Nurse should determine if Poison Control needs to be called. School Nurse should notify the student s parents and physician for additional instructions and orders. Submit a written report within 24 hours on the Medication Error Form. Frequent Questions: 1. Can I train others to administer medications? No! 2. Who can train me to administer medications? Only the Registered School Nurse. 3. What do I need to know and do when accepting medication at school?, First Verify that there is a completed Physicians Authorization form and Parent Authorization form. Next, count the medication and document on back of the Medication Log. 4. After reviewing this PowerPoint, am I trained to administer oral medications? No, your School Nurse will review your test and then determine if you are ready to administer oral medication 5. What should I look for on the medication container? Student s name, prescriptive medication name, dosage and administration time. 6. Can I distribute over-the-counter medication since it is not a prescription? No, it is against the Ohio Revised Code 7. What should I do if I am asked to do something I do not feel okay about doing? Call the School Nurse, building Principal or your direct Supervisor

8 It s Almost Over: Take the medication test below. Print out the test and select your answers on the test sheet. Sign the test. Send to Health Services via the PONY. Demonstrate administration of medication and the Epi-Pen to the School Nurse. Name: School: True or False Over-The-Counter medications require a physician s prescription and parent signature in order to be administered at school. 2. True or False If a student runs out of medication it is okay to use another student s medications until the parent brings in another supply. 3. True or False Asthma inhalers are considered an oral medication. 4. True or False You can be held liable if something happens to a student after receiving a medication even if you followed all procedures properly. 5. True or False Under no circumstance can a student carry an inhaler.

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