MEDICATION ADMINISTRATION FOR NON-LICENSED STAFF

1. MEDICATION ADMINISTRATION FOR NON-LICENSED STAFF SUMNER SCHOOL DISTRICT

2. School Health Issues • A federal mandate created in the 1970s obligated schools to provide children with medical services, including medication administration. Schools are asked to manage medications that may include controlled substances, emergency and psychotropic medication, and to provide a range of therapeutic interventions for chronic illnesses such as diabetes and asthma

3. WHY? • This presentation was developed to allow you to orient to medication administration at your convenience. • There is a post-test at the end. • Print the test, answer the questions, sign and send the completed answer form to health services at district office. • You will still need to be checked off on the administration of an Epi-Pen.

4. What can I expect to learn from this training… • After reviewing this presentation, am I trained to administer oral medication? • What are oral medications? • Can I train others to administer medications? • Who can delegate and train me to administer medications? • What steps do I follow for the safe administration of oral medications? • What do I need to know and do when accepting medication at school? • What should I look for on the medication container? • What should I do if I make a medication error? • Can I distribute over-the-counter medication since it is not a prescription? • What should I do if I am asked to do something I do not feel comfortable doing?

5. Confidentiality of Student Health Records • State and federal law impose restrictions on handling student health records • Medication administration records are considered confidential information • Generally, health care information contained in school records cannot be disclosed to anyone without the consent of a parent or a student who is 18 years of age or older

6. Medication Administration • Oral Medication (both prescribed and over-the-counter) administration is governed by Statute (RCW 28.A210.260 and 270). • The law authorizes school districts to implement policies and procedures so that students can receive oral medication at school • Asthma inhalers are considered oral medications • All medications need a licensed health care provider order and parent signature.

7. What are oral medications? • Oral medications are those taken by mouth. They need not be swallowed, but may be inhaled through the mouth. • Oral medications administered through a gastrostomy tube are also considered oral, based on regulations of WAC 246-840-920[16].

8. Sumner School District Medication Policy/Procedure • The building district Registered Nurse (RN) may delegate giving oral medication to Sumner School District staff • Licensed Health Care Provider orders and parent permission are required before medication can be administered • New orders are required for each school year • Parents may come and administer medication • The district RN needs to be consulted and approve the medication order before administering the first dose of any medication • Medication must be in the original pharmacy labeled container • Medication directions on the container must match the provider order • Only a licensed nurse can accept a change in medication orders • The only injectable medication accepted by the school is insulin, EPI-Pen, and glucagon.

9. Medication ProcessContinued • Medication must come to school in the original container with student’s name, medication name, dosage, and time to be given on the label • A responsible adult must bring medication to school • Medications should be kept in a locked cupboard at all times • Medication should be counted and recorded on the medication received form upon receiving it at school

10. Medication Procedure • In certain situations, such as “SPECIAL NEEDS” programs not easily accessible to the health room, medication can be kept in a locked cabinet. The medication cabinet is to remain locked at all times

11. Remember…….. • Never give medication without all instructions and a properly labeled container • Never give medication if the written information (order) does not match the label on the container • Remember you must get permission from the district RN prior to administering any medication(s) to a student OR for a change in any medication order • Contact the school nurse if you have any questions prior to giving the medication

12. Medication Training • School staff who will be administering medications will be trained by the building’s district Registered Nurse • Training shall be done yearly • Administrative assistants, paraeducators, teachers, and coaches can all be trained to give oral medication and administer an Epi-Pen • Individuals who have not received training from the district RN cannot administer medication

13. The “Five Rights” • Remember these five rights when administering medication to students: • Right Student • Right Medication • Right Dosage • Right Time • Right Route

14. Hand Washing • Hand washing is the single most important practice for the preventing transmission of germs • Hand washing should be done often • It is important to follow hand washing procedures before and after administering medication to the student

15. Administration of Tablets, Capsules, or Liquids • Read the medication label when picking up the container • Ask the student to state his/her name, review photo (if unsure who student is and photo is available) • Read the label again and pour the pill into the cap of the medication bottle or liquid into a measuring device • Administer the medication • Stay with the student until you are sure the medication has been swallowed • Document the medication was given on the “Medication administration record” sheet with the time given and your initials

16. Inhaler Use • Administration steps: • Student should • Remove mouthpiece cover • Shake inhaler well for 2 to 5 seconds • Take a deep breath and exhale completely • Place mouthpiece in mouth • Inhale slowly and deeply through mouth, depress medication canister fully and hold his/her breath for 10 seconds

17. Pouring Liquid Medication • Identify student • Take medication out of locked cabinet • Compare order to label • Pour medication at eye level into dispensing cup • Identify student again • Administer medication • Document medication administration on the Medication administration record

18. Administration of an Epi-Pen • Read the 3 step process • Pull off safety cap • Place tip on outer side of thigh, stabilize the thigh and you may inject through clothing • Press forcefully to activate the mechanism and hold pen in place for 10 seconds • Dispose of Epi-Pen in a sharps container • Massage the injection area for 10 seconds • 911 must be called anytime you suspect a life threatening allergy (anaphylaxis) and the Epi-Pen is administered NOTE: You must demonstrate the skill of using the Epi-pen trainer to the district registered nurse

20. Medication Error Reporting If you have made a medication error: • Keep the student in the health room • Monitor the student’s status • Staff should immediately notify the district registered nurse, principal and parent • The district registered nurse will determine if poison control should be called • Complete the Medication Error Report form which can be found on docushare

21. Professional Responsibility • After reviewing this PowerPoint, am I trained to administer oral medications?No, your school district registered nurse will review your test and then determine if you are ready to administer oral medications • What are oral medications? Medications administered via the mouth, an inhaler, and gastrostomy medications • Can I train others to administer oral medications? No • Who can delegate and train me to administer medications? Only the district registered nurse • What steps do I follow for the safe administration of oral medications? The 5 rights of medication administration • What do I need to know and do when accepting medication at school? Count the med (with the parent or another staff member), log and sign the medication received form and call your school registered nurse before administering the first dose! • What should I look for on the medication container? Student’s name, prescription medication name, dosage, and time of dosing • What should I do in case of an error? Keep the student in the health room and notify the principal, district registered nurse and complete a medication error report form • Can I distribute over-the-counter medications since it is not a prescription? No!!! • What should I do if I am asked to do something I do not feel okay doing? Call the district nurse!

22. It’s Almost OVER!!! • Take the medication administration test that follows this page • Print out the test sheet and select your answers • Sign the test • Give to district nurse OR send to health services at district office • Demonstrate administration of the Epi-Pen to the district registered nurse • Sign the Medication Administration Delegation Sign-Off Form

23. MEDICATION ADMINISTRATION TEST 1. T F Over-the-counter medications require a licensed health care provider order (prescription) and parent signature in order to be administered at school • T F The school district registered nurse needs to be consulted before you can administer the first dose of any oral medication 3. T F Call 911 if student is given Epi-pen 4. T F Only a licensed nurse can accept a change in medication order 5. T F An Epi pen is held in place for 5 seconds before removing 6. T F If a medication error occurs you do not need to contact the district registered nurse • T F All staff need field trip training prior to administering medications on field trips • T F It is ok to share health related information with any staff member • T F The five rights consist of the right: dose, time, place, route, student • T F Students with asthma and anaphylaxis have a higher risk for severe reaction *I understand and I am willing to assume the medication administration responsibility. Signature_________________________________________ • **I under • Signature_____________________________________