SPRINGFIELD PUBLIC SCHOOLS COMPREHENSIVE SCHOOL HEALTH PROGRAM Administration of Medication in Springfield Public Schools

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1 SPRINGFIELD PUBLIC SCHOOLS COMPREHENSIVE SCHOOL HEALTH PROGRAM Administration of Medication in Springfield Public Schools LAW: Massachusetts General Law, Chapter 94 C These medical guidelines are established for the student requiring the Administration of Medication in the school setting. All students requiring medication administration in the school setting are entitled to efficient and proper delivery of all prescribed medication for optimal treatment. Therefore, it is the school nurse s responsibility to follow the physician s order and in the safekeeping and delivery of all prescribed medication in a timely fashion. Policy: 1. Standard Medication Orders Students requiring medication administration during the school day will require a Medication Authorization form to be completed by the licensed prescriber and the parent/guardian for each medication. This includes all daily, PRN, over the counter, short term, and investigational medications. See following form (MED FORM 1). 2. Short Term Prescription Medications For medications requiring administration for ten school days or fewer, the pharmacy labeled container may be used in lieu of a Medication Authorization completed by the licensed Prescriber. Parent/guardian permission is required. If the school nurse has a concern or question, s/he may request a Medication Authorization completed by the licensed prescriber. 3. Over The Counter (OTC) Medications If a child requires an OTC medication during school hours, the parent/guardian must Complete the Care Of Emergency Illness or Accident form. Standing orders for OTC medication can be administered per school and grade specific Standing Orders. See following pages. If a student requests an OTC medication for five or more days, the parent/guardian will be notified and referred to the student s PCP. See following forms (MED FORM -2 OTC). 4. Hours of Medication Administration Medication administration in school will be between the hours of 11:00am and 12:30pm. Exceptions will be on an individual basis and must be approved by the Nursing Supervisor. 68

2 5. Narcotics Narcotics will not be administered in the school setting. Students requiring narcotics are advised to remain at home. Children with chronic illness whose physician has indicated that Tylenol with codeine is indicated during school may receive an exception from the Nursing Supervisor. 6. Medication Renewal All medication orders expire at the end of each school year and must be renewed at the beginning of each new school year, or as necessary. 7. Verbal Orders All verbal orders received from a physician, or nurse practitioner must be followed by a written order within three school days. 8. Medication Supplies It is the parent/guardian s responsibility to supply the school nurse with the medication in the original pharmacy labeled container, completed Medication Authorization, timely refills, and necessary equipment for the proper delivery of the medication. A five day supply of Tylenol with codeine may be kept in school for those students who have met the requirements for an exception. 9. Medication Administration Plan The school nurse will establish a Medication Administration Plan for each student receiving a medication. The plan should include input from the school nurse, student, parent/guardian, licensed prescriber, teacher, principal, and other relevant staff. 10. Medication Administration The administration of medication must be performed by a trained licensed health professional following clinical guidelines in the nurse s office. Exceptions can be made for emergencies and students with handicaps with prior approval from the Nursing Supervisor. Medication will be administered on time, a 60 minute grace period before or after the scheduled time is acceptable, following the 5 Rights: Right Student Right Medication Right Route Right Dose Right Time 11. Identification All students must be properly identified prior to the administration of medication. The school nurse will state the student s name and the student will repeat it to the school nurse. Identifying pictures should be included in the medication administration plan or the teacher/principal can verify the identity of the student. 69

3 12. Self Administration Students are not allowed to carry medication on their person unless they meet the Self Administration guidelines which include a licensed prescriber s order, parent/guardian permission, school nurse approval, and agreement by the student with demonstration of appropriate knowledge. See following form. (MED FORM -3) 13. Documentation It is the school nurse s responsibility to maintain clear, current, and organized Medication Records of all medications administered during school hours. These records are a permanent part of the students cumulative Health Record and may not be altered in any way. Medication Records must include: 1. Medication Authorization signed by licensed prescriber and parent/guardian, dated, and signed by school nurse when received a new Medication Authorization must be completed if the order is changed in any way 2. Individual Medication Administration Care Plan for each medication 3. Entry in SNAP 4. Verification that order is correctly completed and entered in SNAP by a second school nurse who then signs the Medication Authorization 5. Documentation in SNAP Medication Log every time the medication is administered or a dose is missed. 14. Medication Error Failure to administer prescribed medication within the appropriate time frame, in the correct dosage, in accordance with accepted practice, to the correct student is considered a Medication Error (Massachusetts General Law, Chapter 94C). In the event of a medication error, the school nurse will notify the Nursing Supervisor and the licensed prescriber and complete a Medication Error Report. See following form (MED FORM 4). Any medication error requiring medical care shall be reported to the DPH: Bureau of Family and Community Health. 15. Medication Storage All medication will be stored in a securely locked cabinet. Keys to the medication cabinet will be carried by the school nurse and a duplicate key will be held by the school principal. After school hours, keys will be stored in a secure location. Any suspected alteration, diversion, or tampering of medications shall be reported to DPHFDA, Nursing Supervisor, Principal, and Police Department. 16. Expired and Unused Medication All unused, discontinued, or expired medication shall be returned to the parent/guardian and documented. At the end of the school year, all medications not retrieved by the parent/guardian will be destroyed and the action will be documented. 70

4 17. Field Trips The school nurse should receive prompt notification of all scheduled field trips from the Administrator. The school nurse will make arrangements and determine a designee for the dispensing of medication during the field trip. A field trip Parent/Guardian Permission Form must be completed for any student requiring medication during a field trip. 18. Resolution to Medication Administration Questions It is the responsibility of the school nurse to resolve any questions or conflicts concerning the appropriate administration of medication during school. It will be necessary for communication to occur among the student, the parent/guardian, relevant school staff members, and health care providers. Final authority for conflicts and questions lies with the consulting school physician. If unable to following the licensed prescriber s order, the school nurse will contact the licensed prescriber, the Nursing Supervisor, and the parent/guardian. 19. School Nurse Absence The school nurse must notify the Nursing Supervisor, Principal, and the covering nurse in case of absence to arrange the administration of medications. 71

5 Over The Counter Medication Protocol Requires the Following: SPRINGFIELD PUBLIC SCHOOLS 1. The Care of Emergency Illness or Accident Form (MED FORM 2 OTC) must be filled out by the parent/guardian. 2. Standing Orders for OTC medications can only be administered per protocol. 3. Standing Orders must be signed by Nurse Practitioner or School Physician. 4. Any student requesting Tylenol or any other OTC medication for 5 or more days. a. Will be asked to see their Provider. b. Parent/guardian will be notified by the school nurse. OTC standing orders and consent forms are school and grade specific. Care of Emergency Illness or Accident form Standing Orders for High Schools. Standing Orders for Middle and Elementary. 72

6 Springfield School Department Standing Orders For School Nurses The following Medication can be administered to students in grades K through 8 th with written permission, and completion of (MED FORM 2 OTC). The School Nurse will follow the Over The Counter Medication Protocol. Ibuprofen Benadryl Triple Antibiotic Ointment Calamine Lotion The following Medication can be administered to students in grades Pre-K through 8, following emergency medication specific protocol. Albuteral Inhaler Albuteral Sulfate Inhalation Solution Epi-Pen Jr or Epi-Pen 73

7 Springfield School Department Standing Orders for School Nurses The following Medication can be administered to students in grades 9 through 12 th with written permission, and completion of (MED FORM 2 OTC). The School Nurse will follow the Over The Counter Medication Protocol.. Ibuprofen Benadryl Triple Antibiotic Ointment Calamine Lotion Calcium Carbonate The following Medication can be administered to students in grades 9 through 12, following the emergency medication specific protocol. Albuteral Inhaler Albuteral Sulfate Inhalation Solution Epi-Pen 74