Nash-Rocky Mount Schools June 2019

1. Medication Administration A training module for school staff Nash-Rocky Mount Schools June 2019

2. Personnel who will be administering medications are required to review this module. • Prior to administering medications to students, the School Nurse will review individual students specific orders with the staff member. • The School Nurse will provide additional one-on-one training to individuals who may be required to administer medications by any route other than oral. View the Nash-Rocky Mount Medication Policy and Procedure on the system website.

3. A “Medication Authorization” form must be signed by a PHYSICIAN and PARENT for PRESCRIPTION and/or OVER-THE-COUNTER medications to be administered by school personnel. • The Medication Authorization form is available in the main office at each school, on the school system’s website, or directly from the school nurse. This permission form is valid for one school year only. If the student’s medication, dosage, or time of administration changes during the school year, a new form must be completed.

4. All prescription medication shall be kept in a container properly labeled by a pharmacist with the child's name, the name of the medication, dosage, time and frequency to be given. • All non-prescription medication shall be in the original container, properly labeled with the child's name and instructions for administration. • Pillboxes, plastic bags, unlabeled bottles, etc. will not be accepted.

5. Students with certain conditions, such as diabetes, asthma and/or anaphylactic reactions, may need to possess and self-administer medication on school property. These medications would be considered emergency medications. The health care provider will indicate “self-carry” on the authorization form. • For students using emergency medications (inhalers or epinephrine autoinjectors) or diabetes medications (insulin, glucagon) the School Nurse will : • Verify that the student understands, has been instructed in self-administration of the medication, and has demonstrated the skill level necessary to use the medication and any accompanying device.

6. The school will not be responsible for the transportation of medication to and from school. It is the responsibility of the parent to ensure that proper medication is brought to school and provided to the appropriate school official and to assure that the appropriate written permission is provided. Medication Disposal • It is the parent’s responsibility to pick up the medication from the school when discontinuedor at the end of the school year. If medication is not picked up within the required time frame, it will be disposed. • The school nurse will conduct periodic medication audits to ensure that the medication is being dispensed in accordance with school policy.

7. A Medication Log will be kept to document the staff administration of any medication a student receives during school hours. • The school nurse will provide staff with a completed medication log . • If medication orders are received and the nurse is off campus do the following • Call the nurse and inform her of the new medication orders • Fax or email a copy of the new orders to the nurse • The nurse will review the orders and make a medication log and either fax or email it back to the school • If the parent has also brought in medication with the new order- record how much medication was received on the medication log once it is received. • DO NOT give any new medication until the School Nurse has reviewed the orders and completed a medication log. • The log shall include: • student's name, • date and time of medication administration, • name of medication being given, • dosage of medication given • and the signature of the person giving the medication.

8. Document daily when medication has been given by placing your initials in the box for the date given. Record the time administered. • Always write in permanent ink. • Medication may be administered up to 60 minutes before or after the scheduled time. • Place the appropriate code in the box if you did not give the medication. • Make sure you sign and place your initials in the signature block of the log. Notify the nurse if: • the parent is not providing medications • missed dosage • the student is refusing to take medications or • for any other problems with medications.

10. Ask the student his/her name or call name before medication is given. • “What is your name?” • Are you “Johnny Depp”? • “Johnny please come here” • Having a photo ID of the student attached to the medication log is helpful.

11. Check prescription bottle for correct prescription information. • Check Medication Log to be sure information is the same. • Right Dose • Check dose listed on prescription bottle • Check dose that is listed on the log. • Do not give if dose does not match.

12. Check time to give medication on log and bottle. • Medications must be given within a 60 minute window of the time ordered. • Example: If the medication is written to be given at 12:00pm; you can give it anytime between 11:00 and 1:00. 5. Right Route • Make sure that you give the medication the way it is ordered to be given!! Most medications you give will be given by mouth. • Call the school nurse with any questions about the proper route for medication administration.

13. AFTER giving the medication • Sign your initials in the corresponding date on the log • Indicate the time the medication was administered on the log • Follow the codes provided for missed doses and make a notation in the comments section if necessary.

14. Most medications given at school will be given by mouth. • Common forms for oral medications are: • tablets, capsules or liquids. • Other routes for administering medications are: • Inhaled • Drops for the eye or ear • Injected • Rectal • Before administering medication by any route- best practice is to wash your hands

15. Tablets or capsules are medications given by mouth (oral) • Only break tablets that are scored. Do not open any capsules or break/crush any tablets unless the physician/parent specifically requests it. • Medications that need to be cut should be sent in pre-cut by the parent/guardian. • Have water available for the student • Open the medication bottle • Pour the ordered number of tablets/capsules into the lid • Have the student take the pill from the cap • Observe the student putting the pill in his mouth and swallowing the medication

16. When measuring liquids use a medication cup/syringe or medication measuring spoon. • Sit measuring cup on a flat surface and measure at eye level • When pouring medication, hold the bottle with label facing your palm to protect the label from spills • If more than 1 liquid medication is ordered, use separate measuring cups • Observe the child swallowing the medication • Check if medication requires refrigeration. • Refrigerated medications should be kept separate from food and stored in a secure area.

17. Check the medication log for correct ear to administer medication to. • Roll the bottle between your hands to warm the medication. • Have student lay or sit with head lying on table with affected ear up. • Pull top part of the ear up and back to open up the ear canal. • Place correct number of drops in ear canal. Release the ear. • Have student remain in this position, for several minutes to ensure absorption of medication.

18. Check the medication log for proper eye to administer medication to. • Pull the lower lid down and apply medication to the inner lower lid. • Apply eye drops one drop at a time with student lying down if possible. • If the student does not tolerate having the eye manipulated • Have the student close his eye; administer the drop to the inner corner of the eye • Have the student open his eye; the eye drop will now go into the eye • Do not touch any part of the eye with the tip of the eye dropper. • Do not allow student to rub eyes. Blotting with a tissue is okay.

19. Field Trips are considered a part of the school day and therefore, medications that are required during the school day must also be provided on a field trip. • While on a field trip, a staff member trained to administer medication will accompany the student. A single dose of medication will be packaged by the school nurse and sent on the trip in a securelocation. If the school nurse is unavailable to package a single dose, the entire bottle will be taken.

20. School personnel assume no liability for complications or side effects of medication when administered in accordance with the instructions provided by the parent/guardian, physician or healthcare practitioner. • Your School Nurse will provide you with any additional training specific for your student population. Complete the quiz