Medication Administration
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  • The law in Oregon which elates to administering medication to students by school personnel was amended in 1997 (See Appendix A) The siginificant changes to this law include dthe following:
  • Never give medication that was not provided by the parent due to the risk of allergic reactions
  • The definition of physician includes these people licensed by the respective licensing board in the state of Oregon or an adjoining state. OAR’s : Expands definition of physician Defines medication as prescription and non-prescription Defines authorized training Outlines parental instruction Defines physician instruction Outlines school district policy requirements Excludes dietary/food supplements
  • Student must be developmentally able
  • Unused medication should be picked up by parent, not sent home with student

Medication Administration Medication Administration Presentation Transcript

  • Medication Administration Annual Review A Training for School Personnel February 2007 Revised June 2008 Begin Exit
  • Welcome to KCSD annual medication administration re-training. This program contains information required by law to administer medications to school students. In order to complete this training, you must have previously attended a course presented by one of the nurses. Please read all of the information and complete the quiz. Following the quiz, there is a survey. This information is required and will assist in improving this course and developing others. You must include your name, building, and date. This information is required for our records. If this is your first time completing this course, allow 1/2 hour to do so. Next Back Exit
  • Goal
    • This training is intended for non-nurse school staff who have been assigned to give medications in school, following the legal guidelines of ORS 339.867 to 339.870 and OAR 581-021-0037 .
    • Next Back
    Exit
  • The Law
    • Administrative rules were adopted by the Oregon Department of Education in 1997, and amended by the legislature in 2007.
    • School districts must adopt policies and procedures for this rule including policies which address student self medication.
    Back Next Exit
  • What the Law Says
    • Administrator must select regular and back up staff
    • Designated school personnel are REQUIRED to receive training annually
    • ONLY trained staff can administer medication
    • Training program must be approved by Oregon Department of Education
    Back Next Exit
  • Oregon Dept of Education
    • Initial training must occur face-to- face with a nurse
    • Annual retraining can be completed online
    Next Back Exit
  • Note:
    • Only non-injectable medications are covered by this law
    • Nebulizer treatments, injections and rectal medication administration will not be taught in this training
    Back Next Exit
  • Three Types
    • Non-prescription medication
    • Prescription medication
    • Student self-administered medications
    Back Next Exit
  • Non-Prescription Medication
    • Commercially prepared
    • Original container
    • Non-alcohol based
    • Necessary for student to remain in school
    • Includes cough drops and antacids (e.g. Tums)
    Back Next Exit
  • Non-Prescription Medication
    • Require:
      • Written parent permission & instructions
        • Can be faxed
      • Student name
      • Medication name
      • Medication dosage, frequency, route
      • Must provide own medication
    Back Next Exit
  • Prescription Medications
    • Law requires school personnel to be responsible only for prescription medication scheduled to be given during school hours.
    Back Next Exit
  • Prescription Medication
    • Does not include injectable drugs
    • Must be prepared and labeled by a U.S. pharmacist and be in the original pharmacy container
    Back Next Exit
  • Prescription Medication
    • Requires written instruction from a physician
      • Prescription label meets this requirement
    • Requires signed permission and instruction from parent
      • Medication Permission Form
    • New medication permission form must be completed each year
    • Administered only if required during school hours
    Back Next Exit
  • These People Can Write Orders:
    • Doctor of medicine/osteopathy/naturopathy
    • Physician assistant
    • Nurse practitioner
    • Dentist
    • Optometrist
    Back Next Exit
  • Student Self-Medication
      • Student must be able to carry and self-medicate, without assistance
      • No staff documentation necessary
      • Must be in original container
      • May only carry one days supply at a time
    Back Next Exit
  • Self-Medication Changes for 2008-2009
    • Can self-medicate at all schools
    • Requires Self-Medication Permission Form
    • Requires medical order
      • Only for prescription medication
      • Can be on the label
    • Requires principal permission
      • Can be revoked
    • Requires parent to provide back-up inhalers & EpiPens to be kept in the office
    Next Back Exit
  • Routes of Medication
    • Oral
      • Tablets, capsules, elixirs or suspensions
    • Topical
      • Skin, eyes, ears, nose
    • Inhaled
      • Mouth or nose
    Back Next Exit
  • Oral Medication
    • Oral medicine should be followed with water
    • Obtain water from a clean source
    • Do not obtain water from sink where first aid provided
    Back Next Exit
  • Oral Medication
    • Tablets requiring cutting should be cut at home and sent to school
    • Parents should provide pill crusher if pills need to be crushed
    • Have parents provide calibrated spoon/cup if needed for liquid medication
    Back Next Exit
  • Topical Medication Ointments
    • Apply to a clean surface
    • Do not apply with your bare hands
    • Use a cotton tipped applicator or gauze pad to apply medication
    Back Next Exit
  • Topical Medication Eye Drops/Ointment
    • Administer with student laying down or head tilted back
    • Apply drops or ointment without touching container to eye or skin
    • Do not administer directly to eyeball
    • Apply to inner portion of eye, close to nose
    Back Next Exit
  • Topical Medication Ear Drops
    • Lay child on side opposite of ear you are medicating
    • While gently pulling up and back on ear, instill correct number of drops
    • Do not touch tip of container to ear or skin
    • Leave child on side for a short time
    Back Next Exit
  • Topical Medication Nose Drops
    • Have student lay with head back over a rolled pillow
    • Instill drops in nostril
    • Keep student in this position for a few minutes
    • Observe for signs of choking or vomiting
    Back Next Exit
  • Inhaled Medication
    • Student should be capable of self-administering inhaler
    • If student continues to experience difficulty breathing 5 minutes after using inhaler
      • Call parent and/or 9-1-1
    Back Next Exit
  • Five Rights
    • Right student
      • Always ask the students name
    • Right medication
      • Check the label
    • Right dose
      • Check the label
    • Right time
      • Can be given 30 min before or after the time stated on the label
    • Right route
      • Check the instruction on the label
    Back Next Exit
  • Safe Storage and Handling
    • Store medications in a clean, locked cabinet
    • NEVER administer medications from an unlabeled container
    • Narcotics, stimulants, and barbiturates should be counted upon arrival at school
      • May be counted with parent or trained school staff
      • Check with district nurse if you are unsure
    Back Next Exit
  • Safe Storage and Handling
      • Medication should be brought to school and returned home by the parent. Do not allow students to carry medications home
      • Changes in medication instructions must be made by parent and/or physician in writing. DO NOT act on verbal requests
      • Only a licensed nurse can take verbal orders from a physician
    Back Next Exit
  • Safe Storage and Handling
    • Refrigeration is necessary for some medications
    • Many liquid medications need to be shaken well
    • Beginning 2008-2009 refrigerated meds need to be locked
      • District will provide lock boxes
    Back Next Exit
  • Handling Medications
    • Always wash your hands
    • Avoid touching medication
    • Wear gloves if placing medication in student’s mouth
    Back Next Exit
  • Handling Medications
    • Do Not leave meds unattended
    • Prepare for one student at a time
    • Compare medication label with Medication Log
    Next Back Exit
  • Disposal of Medication
    • Notify parent of unused medication
    • Any unclaimed medication should be placed in sealable container in the presence of two staff members
      • Prescription Medication must be counted and the number of pills documented
    • Bring sealed container to DO during secretary check-out
    • Note parent contact and medication disposal on M edication Log ; sign by both staff members
    Back Next Exit
  • Record Keeping
    • Legal document
      • Ink
      • Students legal name and DOB
      • Medication Permission Form
      • Medication Log
      • Sign initials in log right after giving
    Back Next Exit
  • Record Keeping
    • Only one student on each form
    • No white-out
      • If an error is made
        • Put a single line through it
        • Initial and date it
    • If there is a dose change
      • Begin a new line on the Medication Log
    Back Next Exit
  • Retaining Medication Records
    • Send completed forms to the DO
      • If medication is complete
      • The student moves
      • At the end of the school year
    • They will be filed in Student Health Folder
      • In SpEd file if student has an IEP
    Back Next Exit
  • Three Most Common Unexpected Situations
    • Student does not come at scheduled time
    • Student refuses medication
    • Student vomits or spits out medication
    Back Next Exit
  • Student Does Not Come at Scheduled Time
    • Send for Student
    • Document
    • Notify
      • Teacher
      • Parent
      • Nurse
    Back Next Exit
  • Student Refuses Medication
    • Encourage
    • Document
    • Notify
      • Parent
      • Nurse
    Back Next Exit
  • Student Vomits Or Spits Out Medication
    • Document
    • Notify
      • Parent
    • Check for symptoms of illness
      • Fever
      • Stomachache
      • Headache
    Back Next Exit
  • Side Effects & Allergic Reactions
    • All medication can cause side effects or allergic reactions
    • Know where EpiPens are kept and who is certified to use them
    • Teachers should be aware of students taking medication
    • Report promptly any unusual symptoms or behaviors to district nurse and parent
    Back Next Exit
  • Prevent Errors
    • Take your time
    • Do not allow yourself to be rushed
    • Work with one student at a time
    • Always follow the “5 rights”
    • Record medication immediately after giving on the Medication Log
    Next Back Exit
  • What Are Medication Errors?
      • Dose not given
      • Medication given to the wrong student
      • Inaccurate dose or wrong medication
      • Wrong time
      • Incorrect route
    Back Next Exit
  • Medication Errors
    • Accidents Happen
    • Report medication errors immediately to district nurse and building administrator
      • Nurse will contact parent
    • Complete Accident/Incident Analysis
    Back Next Exit
  • Field Trips and Off- Campus Activities
    • PLAN AHEAD!
    • Staff person trained in medication administration must accompany group if medications will be required
    • Document administration on a copy of the Medication Log while on field trip and on the original when you return
    • Recommend notifying nurse two weeks prior to trip if medication training is necessary
    Back Next Exit
  • Field Trip Supplies
    • Copy of Medication Log
    • Medication in original container
    • Hand cleaner
    • Drinking water
    • Safe container to transport
    Back Next Exit
  • Confidentiality
    • Student medication files are CONFIDENTIAL
    • Access limited to school staff with a legitimate “need to know”
    • Parent/Guardian authorization is required for release of information
    Back Next Exit
  • Remember!
    • Once KCSD has received a signed permission slip and medication, it is our responsibility
      • To administer it appropriately and on time (30 mins before or after time on prescription)
      • Monitor medication supply
    Back Next Exit
  • Parent Communication
      • Avenues of communication to parents:
        • Registration
        • Student Handbooks
        • School Newletters
        • Informational Packets
    Back Next Exit
  • Dealing with Concerned Parent
    • Validate parent emotions
    • Remind them - student safety is the priority
    • Share written information
    • Include district nurse and administrator
    • Set boundaries and ensure your own safety
    Back Next Exit
  • Establishing a Cooperative School Environment
    • Success requires a team effort
    • Include teacher in planning student’s medication needs
    Back Next Exit
  • Staff Protection
    • School staff are protected by careful observation of regulations of the medication law, rules, district policy
    • Nurse’s responsibility is to provide proper training
    • Your responsibility is to follow the instruction
    Back Next Exit
  • Remember!
    • NO Baggies
    • NO Envelopes
    • NO Medication Boxes
    Back Next Exit
  • If you have any questions or concerns call a nurse before giving the medication Next Back Exit
  • Medication Administration Quiz Begin Exit
  • Question #1
    • Never give medication sent to school in a baggie.
    • True
    • False
    Exit
  • Correct
    • All medication must be in the original container properly labeled with the name of the student, name of the medication, dose, route, and frequency of administration.
    • Next question
    Exit
  • Incorrect
    • Law states all medication must be in the original container properly labeled with the name of the student, name of the medication, dose, route, and frequency of administration
    • Back
    Exit
  • Question #2
    • If a parent calls saying the doctor has increased the dose from one pill to two, always follow the parent’s instructions.
    • True
    • False
    Exit
  • Incorrect
    • Medication must be given as directed on the prescription label. Written instructions from the doctor or a new prescription label are required to change the dose.
    • Back
    Exit
  • Correct
    • Medication must be given as directed on the prescription label. Written instructions from the doctor or a new prescription label are required to change the dose.
    • Next question
    Exit
  • Question #3
    • Once a staff member has been trained to give medication by the nurse, they only need more training if the laws regarding medication administration change.
    • True
    • False
    Exit
  • Incorrect
    • Oregon law states yearly instruction must be provided to designated school staff on the administration of medication.
    • Back
    Exit
  • Correct
    • Oregon law states yearly instruction must be provided to designated school staff on the administration of medication.
    • Next question
    Exit
  • Question #4
    • A good way to assure the appropriate students receive their medication each day is to keep a list on the cabinet or refrigerator
    • True
    • False
    Exit
  • Correct
    • Student medication information is confidential and should be shared only with staff who have a legitimate “need to know”
    • Posting such information where students, parents, general staff can view it is a breech of confidentiality
    • Next question
    Exit
  • Incorrect
    • Student medication information is confidential and should be shared only with staff who have a legitimate “need to know”
    • Posting such information where students, parents, general staff can view it is a breech of confidentiality
    • Back
    Exit
  • Question #5
    • Alcohol-based cough syrup can be given at school with written permission from a parent
    • True
    • False
    Exit
  • Incorrect
    • The law defines non-prescription medication as: commercially prepared, non-alcohol based medication to be taken at school that is necessary for the child to remain in school. This includes eyes, nose and cough drops, cough suppressants, analgesics, decongestants, antihistamines, topical antibiotics, anti-inflammatories and antacids that do not require written or oral instructions from a physician. Non-prescription medication does not include dietary food supplements
    • Back
    Exit
  • Correct
    • The law defines non-prescription medication as: commercially prepared, non-alcohol based medication to be taken at school that is necessary for the child to remain in school. This includes eyes, nose and cough drops, cough suppressants, analgesics, decongestants, antihistamines, topical antibiotics, anti-inflammatories and antacids that do not require written or oral instructions from a physician. non-prescription medication does not include dietary food supplements.
    • Next question
    Exit
  • Question #6
    • If a parent sends a pill bottle with the students name on it to school and keeps the original pill bottle at home, it is OK to give the medicine.
    • True
    • False
    Exit
  • Correct
    • Prescription medication must be in the original container with a pharmacy label attached
    • Only a licensed pharmacist can legally package and label medication
    • Next question
    Exit
  • Incorrect
    • Prescription medication must be in the original container with a pharmacy label attached
    • Only a licensed pharmacist can legally package and label medication
    • Back
    Exit
  • Question #7
    • When a parent asks you to give their child two Children’s Tylenol for a headache, it is OK to do so if you have the medicine.
    • True
    • False
    Exit
  • Correct
    • Oregon law requires written permission and instruction from the student’s parent to administer non-prescription medication
    • It is the parent’s responsibility to provide a student’s medication
    • Next question
    Exit
  • Incorrect
    • Oregon law requires written permission and instruction from the student’s parent to administer non-prescription medication
    • It is the parent’s responsibility to provide a student’s medication
    • Back
    Exit
  • Question #8
    • When the trained medication person is absent, the principal can have another staff member give medicine even if they have not been trained.
    • True
    • False
    Exit
  • Incorrect
    • Law states school staff designated to administer medication must receive yearly training
    • Back
    Exit
  • Correct
    • Law states school staff designated to administer medication must receive yearly training
    • Next question
    Exit
  • Question #9
    • Any student can carry and administer their own non-prescription medication if their parent writes it on the permission slip.
    • True
    • False
    Exit
  • Incorrect
    • Any student may carry and self-medicate non-prescription medication with:
      • Written parental permission Self-Medication Permission Form
      • Principal permission
    • Medication must be in original container
    • Student may only carry one days supply of medication at a time
    • Back
    Exit
  • Correct
    • Any student may carry and self-medicate non-prescription medication with:
      • Written parental permission Self-Medication Permission Form
      • Principal permission
    • Medication must be in original container
    • Student may only carry one days supply of medication at a time
    • Next question
    Exit
  • Question #10
    • Students may carry and self-administer cough drops as long as their parent sends them with the student
    • True
    • False
    Exit
  • Correct
    • Cough drops and antacids (e.g. Tums) are considered non-prescription medication and require:
      • Student to provide their own medication
      • Written parental permission & instructions to include:
        • Student name
        • Medication name
        • Medication dose, frequency, route
    • Next question
    Exit
  • Incorrect
    • Cough drops and anti-acids (Tums) are considered non-prescription medication and require:
      • Student to provide their own medication
      • Written parental permission & instructions to include:
        • Student name
        • Medication name
        • Medication dose, frequency, route
    • Back
    Exit
  • Question #11
    • All medication should be stored in a clean, locked cabinet.
    • True
    • False
    Exit
  • Correct
    • All medication should be stored in a clean, locked cabinet
    • Refrigerated medication must be stored in a locked container in the refrigerator
    • Next question
    Exit
  • Incorrect
    • All medication should be stored in a clean, locked cabinet
    • Refrigerated medication must be stored in a locked container in the refrigerator
    • Back
    Exit
  • Question #12
    • If a student vomits after taking their medication, be sure to send a note home to the parent.
    • True
    • False
    Exit
  • Incorrect
    • If a student vomits after taking their medication
    • Document
    • Observe for signs of an allergic reaction
    • Check for signs of illness
    • Contact parent
    • Back
    Exit
  • Correct
    • If a student vomits after taking their medication
    • Document
    • Observe for signs of an allergic reaction
    • Check for signs of illness
    • Contact parent
    • Next question
    Exit
  • Question #13
    • When an eighth grade student does not come for their medication, it is their own problem; they are old enough to be responsible.
    • True
    • False
    Exit
  • Incorrect
    • Once we have received medication and a signed permission slip from a parent, we are responsible for getting the medication to the student within ½ hour of the designated time
    • If a student does not come for scheduled medication
      • Send for the student
      • Back
    Exit
  • Correct
    • Once we have received medication and a signed permission slip from a parent, we are responsible for getting the medication to the student within ½ hour of the designated time
    • If a student does not come for scheduled medication
      • Send for the student
    • Next question
    Exit
  • Question #14
    • When a student requiring medicine is going on a field trip, put their pills in a zip-lock bag with the students name and instructions, and give them to the teacher.
    • True
    • False
    Exit
  • Incorrect
    • Prescription medication must be in its original container with a proper pharmacy label attached
    • non-prescription medication must be in its original container, labeled with the students name
    • Anyone dispensing medication at school must receive annual, ODE approved training.
    • Back
    Exit
  • Correct
    • Prescription medication must be in its original container with a proper pharmacy label attached
    • non-prescription medication must be in its original container, labeled with the students name
    • Anyone dispensing medication at school must receive annual, ODE approved training.
    • Next question
    Exit
  • Question #15
    • A student is given the wrong medication in error. The best thing to do is make the student vomit the medicine.
    • True
    • False
    Exit
  • Incorrect
    • Never induce vomiting
    • Medication errors must be reported to the nurse immediately
    • Medication errors include:
      • Failing to give a dose
      • Giving medication to the wrong student
      • Giving medication at the wrong time
      • Giving the wrong medication or the wrong dose
      • Giving the medicine by the wrong route
    • If a nurse is not immediately available, you may call Poison Center 1-800-222-1222.
    • Back
    Exit
  • Correct
    • Never induce vomiting
    • Medication errors must be reported to the nurse immediately
    • Medication errors include:
      • Failing to give a dose
      • Giving medication to the wrong student
      • Giving medication at the wrong time
      • Giving the wrong medication or the wrong dose
      • Giving the medicine by the wrong route
    • If a nurse is not immediately available, you may call Poison Center 1-800-222-1222
    • Next question
    Exit
  • Question #16
    • Teachers should know when their students are taking medication, in spite of confidentiality laws.
    • True
    • False
    Exit
  • Correct
    • Teachers have a “legitimate educational interest” in students taking medications
    • All medication has the potential to cause side effects
    • All medication has the potential to cause an allergic reaction
    • Next question
    Exit
  • Incorrect
    • Teachers have a “legitimate educational interest” in students taking medications
    • All medication has the potential to cause side effects
    • All medication has the potential to cause an allergic reaction
    • Back
    Exit
  • Question #17
    • Always use pencil when recording medications so that you can make changes if a mistake is made.
    • True
    • False
    Exit
  • Incorrect
    • Medication records are legal documents
    • Must be written in ink
    • When you write on the medication log, initial what you have written
    • If your initials are on the log, place your initials and signature in the appropriate spot on the bottom of the log
    • Back
    Exit
  • Correct
    • Medication records are legal documents
    • Must be written in ink
    • When you write on the medication log, initial what you have written
    • If your initials are on the log, place your initials and signature in the appropriate spot on the bottom of the log
    • Next question
    Exit
  • Question #18
    • At the end of the year, send all of the medication logs to Health Services at the DO.
    • True
    • False
    Exit
  • Correct
    • Send completed Medication Logs to the DO
      • If the medication is complete
      • The student moves
      • At the end of the school year
      • Next question
    Exit
  • Incorrect
    • Send completed Medication Logs to the DO
      • If the medication is complete
      • The student moves
      • At the end of the school year
      • Back
    Exit
  • Question #19
    • When the prescription label says to give the medicine at 12:00 and lunch is at 11:45, it is OK to give before lunch.
    • True
    • False
    Exit
  • Correct
    • Medication is to be given within ½ hour before or after the designated time
    • Next question
    Exit
  • Incorrect
    • Medication is to be given within ½ hour before or after the designated time
    • Back
    Exit
  • Question #20
    • The 5 Rights of Medication Administration include:
    • Right Student
    • Right Medication
    • Right Dose
    • Right Time
    • Right Route
    • True
    • False
    Exit
  • Correct
    • If the person administering the medication always follows the “5 Rights”, it is unlikely an error will occur.
    Next Exit
  • Incorrect
    • Right Student-always ask their name, even if you know them
    • Right Medication-read the prescription label and compare it to the medication log
    • Right Dose-give the exact amount specified by the physician on the label
    • Right Time-check the medication log for the time it is to be given. Up to 30 minutes before or after the prescribed time is OK
    • Right Route-always check the label which will tell you if it is to be taken by mouth, rubbed on the skin, or put in an ear
    • Back
    Exit
  • References
    • Oregon Department of Education. www.ode.state.or.us/groups/supportstaff/hklb/schoolnurses/medicationadmin.pdf Accessed April 21,2007.
    • Oregon Administrative Rules, Chapter 581-021-0037. Administration of Prescription and Nonprescription Medication to Students (2005).
    • Oregon Revised Statutes, Chapter 339.869 Administration of medication to students; rules (2001).
    • Perry, A. G. & Potter, P. A. (2006). Clinical nursing skills & techniques (6th ed.). Philadelphia: Mosby.
    • Next
    • You have now completed the review. Click next to submit the results and complete a survey. The survey must be completed to document your training .
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