Medication Administration in the Childcare Setting

1. Medication Administration in the Childcare Setting Presented by:

2. Policies for Medications Why have policies for giving medication? • Children may require medication during the day to treat a chronic illness or ongoing condition. • Clear policies helps staff be safe and effective. • Policies also help parents understand what to communicate with caregivers about their child’s medication needs.

3. Medication Policies, continued. • Prescription medicines with scheduled dosages such as “every six hours” will require administration during an 8-10 hour day of childcare. • Children with chronic conditions such as asthma may require medication to prevent or treat an asthma attack. • Pain associated with teething or a broken bone may be relieved with the correct dosage of acetaminophen (Tylenol).

4. The 5 RIGHTS when giving medication • List them here

5. Standards • National Health and Safety Performance Standards • National Academy of Early Childhood Programs • Head Start Performance Standards • State Licensing Requirements It is essential that childcare programs have a written policy and clear procedures on giving medications.

6. Over-the-counter (OTC) Medicines • Many childcare programs only give medicines if prescribed or recommended in writing by a physician. • If child needs an OTC medicine (i.e. Tylenol, cold medicine), the parent should ask the doctor or nurse for a written note indicating the mediation dosage and how often it may be given.

7. Obtain Written Authorization • Obtain written authorization from parent BEFORE medicine is to be given. • Must be done with each new medicine that is prescribed or brought into the center. • No “blanket” authorizations. For example, may give acetaminophen for pain, stomach gas or teething. This can lead to potentially dangerous situations. Pain is the body’s signal that something is wrong. It is difficult for a caregiver to know exactly what is causing the pain, so the caregiver should not make the decision to give medicine. If a child has a headache, stomach pain, rash or other discomfort, the parent/guardian should be notified.

8. Good Communication is Key! • Communicate with parents. Require written information on time and dosage of medicines. Written communication is necessary for each day medicine is given. • A medication form should be completed stating the name of the medicine, time it was given and who gave it. • When parent picks up the child, the caregiver should give the parent a written copy of the time and dosage of all medications given.

9. Storage and Disposal of Medications • Store in original, labeled containers in a locked cabinet inaccessible to children. • This requirement applies to all medicines, including OTC products and refrigerated medications. • Parents should take home any medicines at day’s end. Hand medicines to parents and let them put them in child’s back pack or diaper bag. Do not give to child or an older sibling to take home.

10. Staff Training • There should be designated staff members in each center who are trained and authorized to give medicines. • Untrained staff, substitute teachers, or volunteers should not give medicine.

11. Knowledge is Power • Be familiar with the types of medicines that are often given to children. You may ask a pharmacist or physician to discuss with the caregivers the different types of medicine such as pain relievers (acetaminophen, ibuprofen), antibiotics, or cough medicines. • If a parent brings in medicine care giver does not recognize, he/she should question whether this is an antibiotic, a decongestant, etc. • If a child regularly takes a specific medicine and the medicine brought in is a different color or the dosage has changed, question it. Parents can make mistakes and might pick up the wrong bottle of medicine at home. • Be familiar w/ dosages. Many liquid medicines for children are given in dosages of less than one teaspoon. When you see instructions to give 1 tablespoon, you should immediately check with the parents, and verified with the pharmacist or physician. • Make certain OTC medicine is in the original box with instructions. (Know that there is a huge difference in amount of acetaminophen in infant drops, children’s tablets and junior strength. • Do not give a new medicine for the first time in the child care center. (Parents must be present for the first dose in case child is allergic to a medication component.)

12. Practice, Practice, Practice! • The actual amount of liquid in a teaspoon (eating utensil), a measuring teaspoon, a medicine dropper and a medicine spoon may vary greatly. • Always use a medicine dropper, syringe, or a medicine spoon to measure the correct dosage for liquid. • Choose one that allows the child to swallow all the medicine with no medicine left in the dropper/spoon. • Be sure the markings are clearly visible on the dropper/spoon.

13. Keep Complete Records • Know how to complete the authorization and daily medication forms. • Pay close attention to details such as printing clearly the child’s correct name (there might be two children with similar names) and correct use of a.m. and p.m., are essential. • Be sure that the parent as well as the caregiver can read and understand the information. • If you are not sure of the parent’s reading ability, then you should “tell” them the inforamtion as well as giving them the form.

14. Specialized Training • A child with a severe allergic reaction might require epinephrine through injection. • A child with asthma may need emergency help with a bronchodilator. • A child may have medical conditions that might require specialized care, make sure all staff involved with those children are properly trained to deal with not only everyday needs, but emergency situations as well. • Center director should monitor staff when administering medicine to children to help them follow procedures such as 1. Check to make sure staff member has the right medicine, dose, time, route (the way it is to be given) and child. 2. That staff member locks up medicine immediately after use. 3. That staff member completes daily medication form, and writes legibly!

15. Hygiene and Expiration Dates • Clean dropper/spoon, wash it in warm soapy water and rinse. You may then spray it or dip it in mild bleach solutions (one tablespoon bleach to one quart of water), rinse and air dry. • Do not use boiling water to sterilize! • Check expiration dates on all medicines as most should be thrown away afte one year. • Liquids such as antibiotics have a shelf life of about 14 days. Check packages for expiration dates on all OTC medicines. • If the expiration date is not printed on the package, do not use the medicine.