File JLCD-R: Administering Medicines to Students

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DEFINITIONS

 

“Administration” means the provision of prescribed medication to a student according to

the orders of a health care provider.

 

“Health care provider” means a medical/health practitioner who has a current license in

the State of Maine with a scope of practice that includes prescribing medication.

 

“Indirect supervision” means the supervision of an unlicensed school staff member when

the school nurse or other health care provider is not physically available on site but

immediately available by telephone.

 

“Medication” means prescribed drugs and medical devices that are controlled by the U.S.

Food and Drug Administration and are ordered by a health care provider. It includes

over-the-counter medications prescribed through a standing order by the school physician

or prescribed by the student’s health care provider.

 

“Parent” means a natural or adoptive parent, a guardian, or a person acting as a parent of

a child with legal responsibility for the child’s welfare.

 

“School nurse” means a registered professional nurse with Maine Department of

Education certification for school nursing.

 

“Self-administration” is when the student administers medication independently to

him/herself under indirect supervision of the school nurse, when appropriate.

 

“Unlicensed school personnel” are persons who do not have a professional license that

allows them, within the scope of that license, to administer medication.

 

The Superintendent/designee shall be responsible for developing administrative

procedures and/or protocols to implement or supplement this policy

 

ADMINISTRATION OF MEDICATION BY SCHOOL PERSONNEL

 

Parental Request

 

In the event that no reasonable alternative exists, the parent/guardian may request in

writing that medication be administered to the student during the school day. The written

request must include an acknowledgement and agreement that unlicensed personnel may administer the medication as per the health care provider’s instructions. In addition, the

request shall indicate that information regarding the student’s medication may be shared

with appropriate school personnel. Parents may provide the reason (diagnosis) requiring

the administration of medication.

 

Requests shall be valid for the current school year only.

 

Health Care Provider’s Order

 

All parental requests must be accompanied by a written order from the student’s health

care provider substantiating the fact that the administration of a particular medication

during the school day is necessary for the student’s health and attendance in school. Such

order must include:

 

A.        The student’s name;

 

B.        The name of the medication;

 

C.        The dose;

 

D.        The route of administration (e.g., tablets, liquid, drops); and

 

E.         Time intervals for administration (e.g., every four hours, before meals);

 

F.         Any special instructions; and

 

G.        The name of the prescribing health care provider.

 

It is the responsibility of the school nurse to clarify any medication order that he/she

believes to be inappropriate or ambiguous. In accordance with Department of Education

Rule Chapter 40 § 2(B), the school nurse may decline to administer a medication if

he/she believes such administration would jeopardize student safety. In this case, the

school nurse must notify the parent, the student’s health care provider and the school

administrator (i.e., building principal or designated administrator).

 

Renewal of Parent Permission Requests/Forms and Health Care Provider Orders

 

Written parental permission requests/forms and health care provider orders must be

renewed at least annually. Health care provider orders must be renewed whenever there

are changes in the order.

 

Delivery and Storage of Medication

 

The student’s parents shall deliver any medication to be administered by school personnel

to the school in its original container. In the event that this is not practical, the parent

must contact the school to make alternate arrangements.

 

No more than a one-month supply of Schedule II medications shall be kept at school. The parent is responsible for the replenishment of medication kept at school.

 

If the health care provider’s order/prescription is for a medication regulated by the

Federal Narcotics Act, no more than a one-week supply shall be kept at school.

 

The parent is responsible for notifying the school of any changes in or discontinuation of

a prescribed medication that is being administered to the student at school. Parents are responsible for authorizing the removal of the medication from school at the end of the school year or on the last days of the student’s enrollment.  Medication will be discarded appropriately by the school nurse if not removed by the parent or guardian by the last day of the school year.

 

The school nurse shall be responsible for developing and implementing procedures for the appropriate and secure storage of medications kept at school.

 

Recordkeeping

 

School personnel and the student’s parent shall account for and record the number of Schedule II medications brought to school. The number of capsules, pills or tablets, and/or the volume of other medications brought to school shall be recorded.

 

The school nurse shall maintain a record including the parent’s request, physician’s order, details of the specific medications (including dosage and timing of medication), and documentation of each instance the medication is administered (including the date, time, and dosage given.)

 

Records shall be retained according to the current State schedules pertaining to student

health records.

 

Confidentiality

 

To the extent legally permissible, staff members may be provided with such information

regarding medication and its administration as may be in the best interest of the student.

 

Administration of Medication

 

Medication may be administered during the school day by licensed medical personnel

acting within the scope of their licenses.

 

The school nurse, under the administrative supervision of the Superintendent, will

provide direction and oversight for the administration of medication to students.

 

All unlicensed personnel (principals, teachers, education technicians, school secretaries,

coaches, bus drivers, etc.) who administer medication must receive training before being

authorized to do so.

 

Based upon the documentation of training and competency in the administration of

medication, the school nurse will make recommendations to the principal/designee pertaining to authorization of unlicensed persons to administer medication. Training that shall be acceptable for the purpose of authorization of unlicensed personnel is addressed under the section of this policy titled “Required Training of Unlicensed Personnel to Administer Medication.”

 

Administration of Medication During Off-Campus Field Trips and School-

Sponsored Events

 

The school will accommodate students requiring administration of medication during

field trips or school-sponsored events as follows:

 

The school nurse, principal, and, as appropriate, the District’s Section 504

Coordinator and/or IEP Team, will determine whether an individual student’s participation is

contraindicated due to the unstable/fragile nature of his/her health condition, the distance

from emergency care that may be required, and/or other extraordinary circumstances. The

student’s parent and primary care provider will be consulted in making this

determination. The decision will be made in compliance with applicable laws, including

the IDEA, Section 504 and the Americans with Disabilities Act (ADA).

 

The parent must provide the appropriate number of doses needed for the duration of the

field trip or school-sponsored event.

 

When there are no contraindications to student participation, an appropriately trained

staff member will be assigned to administer medication. The parent will be encouraged

to accompany the student, if possible, to care for the student and administer medication.

All provisions of this policy shall apply to medications to be administered during off-campus

field trips and school-sponsored events.

 

1.         Unlicensed personnel administering medication on a field trip must check in with the           school nurse before the trip to receive appropriate training on an as needed basis.

 

2.         There must be written permission from the parent/guardian providing consent to administer the medication in school and a written physician’s order and/or an appropriately labeled, original medication container.

 

3.         The school nurse will provide the information described below on either a label or envelope containing the medication, or the medication will be in its original container for the student attend the field trip.

 

4.         The school nurse shall transfer the prescribed amount of medication needed for the field trip from the original medication container into the approved envelope and fill in the appropriate information on the envelope.

 

5.         The envelope will be provided to the trained personnel for administration during the trip.  The school nurse will provide a review of the medication and its administration to the trained personnel on an as-needed basis.  All trained personnel administering medication must understand what to do in an emergency.

 

6.         The medication will be transported and stored in compliance with any special directions for the medication and will be secured as safely as possible.

 

7.         The administration of medication on a field trip will duplicate as much as possible, the guidelines found in the “Guidelines for Training of Non-Licensed Personnel in Medication Administration.”  This will include consideration of student privacy and cleanliness of area where medications are administered.

 

8.         Medication will be administered to the student to assure that the right student receives the right medication, with the right dose, at the right time, by the right route.  The trained personnel administering the medication will double-check the student with the medication label and will double-check the dose.  The medication will be given within 30 minutes either side of the prescribed time.

 

9.         Each school district will develop a method of documenting medications administered on the field trip, recording any unexpected occurrences, and a method of returning any medication not administered.

                                                                                                           

The medication envelope or label will contain the following information:

 

1.         Date to be administered.

2.         Name of the student.

3.         Name of the medication.

4.         Dose to be given.

5.         Time to be given.

6.         Physician prescribing the medication.

7.         Special directions.

8.         Phone number of school nurse.

9.         Emergency directions if needed.

 

Student Self-Carry/Self-Administration of Medications for Chronic Conditions

 

Students with chronic conditions (such as anaphylaxis allergies, asthma, or diabetes) may be authorized by the building principal, in consultation with the school nurse, to possess and self-administer emergency medication. Emergency medication may include, but is not limited to, epinephrine, asthma inhalers, insulin or glucagon.   These pre-approved medications may be self-administered during the school day, during field trips, school-sponsored events, or while on a school bus. The student shall be authorized to possess and self-administer if the following conditions have been met.

 

A.        The parent (or student, if 18 years of age or older) must request in writing

authorization for the student to self-administer medication.

 

B.        The student must have the prior written approval of his/her primary health

care provider and, if the student is under the age of 18, the prior written

approval of his/her parent/guardian. The written notice from the student’s

primary care provider must specify the name and dosage of the

medication, frequency with which it may be administered, and the circumstances that may warrant its use.

 

C.        The student’s parent/guardian must submit written verification to the

school from the student’s primary care provider confirming that the

student has the knowledge and the skills to safely possess and medicate.

 

D.        The school nurse shall evaluate the student’s technique to ensure proper

and effective use of an epinephrine auto injector or asthma inhaler taking into account the maturity and capability of the student and the circumstances under which the student will or may have to self-administer the medication.

 

E.         The parent will be informed that the school cannot accurately monitor the

frequency and appropriateness of use when the student self-administers

medication, and that the school unit will not be responsible for any injury

arising from the student’s self-medication.

 

Authorization granted to a student to possess and self-administer medication from an

epinephrine auto injector or asthma inhaler shall be valid for the current school year only and must be renewed annually.

 

A student’s authorization to possess and self-administer medication from an epinephrine

auto injector or asthma inhaler may be limited or revoked by the building principal after

consultation with the school nurse and the student’s parents if the student demonstrates

inability to responsibly possess and self-administer such medication.

 

To the extent legally permissible, staff members may be provided with such information

regarding the student’s medication and the student’s self- administration as may be in the

best interest of the student.

 

Sharing, borrowing, or distribution of medication is prohibited. The student’s

authorization to self-administer medication may be revoked and the student may be

subject to disciplinary consequences for violation of this policy.

 

Required Training of Unlicensed Personnel to Administer Medication

 

Unlicensed school personnel who administer medication to students in a school setting (at

school, on school transportation to or from school, on field trips, or during school-sponsored

events) must be trained in the administration of medication before being authorized to carry out this responsibility.

 

Such training must be provided by a registered professional nurse or physician and

include the components specified in Department of Education Rule Chapter 40 and other applicable Department of Education standards, recommendations, programs, and/or

methodologies.

 

The trainer shall document the training and competency of the principal / designee to administer medication.

 

Following the initial training, a training review and information update must be held at

least annually for those unlicensed school personnel authorized to administer medication.

 

Legal Reference:          20-A M.R.S.A. §§ 254; 4009(4)

Ch. 40 (ME Dept. of Education. Rule)

28 C.F.R. Part 35 (Americans with Disabilities Act of 1990)

34 C.F.R. Part 104 (Section 504 of the Rehabilitation Act of 1973)

34 C.F.R. Part 300 (Individuals with Disabilities Education Act)

 

REVIEWED:                        January 12, 2017

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