A Training for School Personnel February 2007 Revised June 2008

1. Medication Administration Annual Review A Training for School Personnel February 2007 Revised June 2008 Exit Begin

2. 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. NextBack Exit

3. 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. NextBack Exit

4. 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. Exit Next Back

5. 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 Exit Next Back

6. Oregon Dept of Education • Initial training must occur face-to- face with a nurse • Annual retraining can be completed online Exit Next Back

7. Note: • Only non-injectable medications are covered by this law • Nebulizer treatments, injections and rectal medication administration will not be taught in this training Exit Next Back

8. Three Types • Non-prescription medication • Prescription medication • Student self-administered medications Exit Next Back

9. 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) Exit Next Back

10. Non-Prescription Medication Require: • Written parent permission & instructions • Can be faxed • Student name • Medication name • Medication dosage, frequency, route • Must provide own medication Exit Next Back

11. Prescription Medications Law requires school personnel to be responsible only for prescription medication scheduled to be given during school hours. Exit Next Back

12. Prescription Medication • Does not include injectable drugs • Must be prepared and labeled by a U.S. pharmacist and be in the original pharmacy container Exit Next Back

13. 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 Exit Next Back

14. These People Can Write Orders: • Doctor of medicine/osteopathy/naturopathy • Physician assistant • Nurse practitioner • Dentist • Optometrist Exit Next Back

15. 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 Exit Next Back

16. 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 Exit Back Next

17. Routes of Medication • Oral • Tablets, capsules, elixirs or suspensions • Topical • Skin, eyes, ears, nose • Inhaled • Mouth or nose Exit Next Back

18. 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 Exit Next Back

19. 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 Exit Next Back

20. 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 Exit Next Back

21. 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 Exit Next Back

22. 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 Exit Next Back

23. 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 Exit Next Back

24. 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 Exit Next Back

25. 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 Exit Next Back

26. 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 Exit Next Back

27. 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 Exit Next Back

28. 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 Exit Next Back

29. Handling Medications • Always wash your hands • Avoid touching medication • Wear gloves if placing medication in student’s mouth Exit Next Back

30. Handling Medications • Do Not leave meds unattended • Prepare for one student at a time • Compare medication label with Medication Log Exit Next Back

31. 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 Medication Log; sign by both staff members Exit Next Back

32. Record Keeping • Legal document • Ink • Students legal name and DOB • Medication Permission Form • Medication Log • Sign initials in log right after giving Exit Next Back

33. 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 Exit Next Back

34. 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 Exit Next Back

35. Three Most Common Unexpected Situations • Student does not come at scheduled time • Student refuses medication • Student vomits or spits out medication Exit Next Back

36. Student Does Not Come at Scheduled Time • Send for Student • Document • Notify • Teacher • Parent • Nurse Exit Next Back

37. Student Refuses Medication • Encourage • Document • Notify • Parent • Nurse Exit Next Back

38. Student Vomits Or Spits Out Medication • Document • Notify • Parent • Check for symptoms of illness • Fever • Stomachache • Headache Exit Next Back

39. 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 Exit Next Back

40. 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 Exit Next Back

41. Dose not given Medication given to the wrong student Inaccurate dose or wrong medication Wrong time Incorrect route What Are Medication Errors? Exit Next Back

42. Medication Errors • Accidents Happen • Report medication errors immediately to district nurse and building administrator • Nurse will contact parent • Complete Accident/Incident Analysis Exit Next Back

43. 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 Exit Next Back

44. Field Trip Supplies • Copy of Medication Log • Medication in original container • Hand cleaner • Drinking water • Safe container to transport Exit Next Back

45. 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 Exit Next Back

46. 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 Remember! Exit Next Back

47. Parent Communication • Avenues of communication to parents: • Registration • Student Handbooks • School Newletters • Informational Packets Exit Next Back

48. 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 Exit Next Back

49. Establishing a Cooperative School Environment • Success requires a team effort • Include teacher in planning student’s medication needs Exit Next Back

50. 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 Exit Next Back