medication administration - ode.state.or.us administration a training for school personnel updated...
TRANSCRIPT
MEDICATION
ADMINISTRATION
A Training for School Personnel
Updated 2016 A special thanks to MESD for their expertise in developing this PowerPoint
and keeping it updated with current regulations.
1
THE LAW
• ORS 339.867-339.870 & OAR 581-021-0037
• Designated school personnel are required to receive ODE approved training
• Districts may not require school personnel to administer medications without appropriate training
• Non-injectable medications
• Districts must adopt policies/procedures for self-administration
• General Intent
2
The Law (continued)
• Designated School Personnel
• Identified by school administrator
• Best to have one point person with a backup in case of absence
• Must have procedures for handling field trips
(including overnight trips) and other events that
occur outside the usual school setting
3
The Law (continued)
• The definition of physician includes these people licensed by the respective licensing board in the State of Oregon:
Doctor of Medicine or Osteopathy (MD/DO)
Physician Assistant
Nurse Practitioner
Dentist
Optometrist
Naturopathic Physician
4
DISTRICT POLICIES &
PROCEDURES
• Each school district shall adopt policies and procedures that
provide for:
• Administration of prescription and non-prescription to students
by trained staff;
• Student self-medication including age appropriate guidelines and
permit self-medication;
• Permit designated staff to administer non-prescription
medication under the written permission and instruction from
parent.
5
District Policies And Procedures
(continued)
• Must include a process to designate, train and supervise
appropriate staff that takes into account when a student is in
school, at a school sponsored activity, under the supervision of
school personnel, in before-school or after-school care
programs on school-owned property, and in transit to or from
school or school-sponsored activities.
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NON-PRESCRIPTION
MEDICATIONS
• Must be commercially prepared, FDA approved and non-
alcohol based.
• Parent’s must have signed written permission, and the dose
must be consistent with the manufacturer’s guideline.
• Must be necessary for student to remain in school.
• Must be in original container.
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PRESCRIPTION MEDICATIONS
• Must be prepared and labeled by a registered U.S. pharmacist,
and in the original bottle.
• Requires written instructions from an Oregon licensed
practitioner. A prescription label meets this requirement.
• Requires written permission from parent.
• Verbal orders/out of state orders can only be taken by the
registered nurse.
• Only if required during school hours
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THE SIX RIGHTS
• Right Student
• Right Medication
• Right Dose
• Right Time
• Right Method of Administering the Medicine
• Right Documentation
These must all be right before any medicine is administered
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RIGHT TIME
• Parent written authorization for any medication must include a
time for the medication to be given.
• Ideally the medication is to be administered at the time
specified. However, medicine may be given up to 30 minutes
before or after time specified and still be the Right Time
10
HANDLING MEDICATIONS
• Obtain water from a clean source, not from the first aid
dedicated sink.
• Always wash hands prior to medication administration.
• Avoid touching the medication.
• Wear gloves if placing medication in student’s mouth.
11
Handling Medications (continued)
• Tablets requiring cutting should be cut by the parent and placed in the
medicine container that is delivered to school.
• Parents must provide pill crusher if student’s medication needs
crushing before giving.
• Parent must provide a calibrated measuring device for measuring liquid
medication.
12
Medication Administration Methods
(continued)
• Administering medicine rectally, by nebulizer or intranasal are
not discussed in this class.
• If a student requires medication by these methods, your school
nurse will initiate an individualized procedure and train
appropriate staff.
15
Medication Administration Methods
(continued)
• Inhalers
Nasal
Oral
Each Metered Dose Inhaler (MDI) has different use and
care, priming, shaking and cleaning directions.
Review insert instructions before use.
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SAFE STORAGE & HANDLING
• Store all medications in their original containers in a secure
locked place.
• Never administer medications from an unlabeled container.
• Never empty medication into a plastic bag or container.
• Never accept medication in a bag or unmarked container.
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Safe Storage And Handling
(continued)
• Certain medications require counting by two individuals upon
arrival at school. See your District policy.
• When refrigeration is required for the medication,
place in a dedicated space in the refrigerator and
in a sealed container.
• Discuss and make plan with administrator for
medication removal in the event of an emergency
evacuation.
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Safe Storage and Handling
(continued)
• All medications are to be brought to school and returned home
by the parent/guardian/designated adult.
• All changes in medication instructions must be made by the
parent in writing. We cannot accept a verbal request from a
parent.
• At the end of the school year parents are to pick up any unused
medicines.
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Safe Storage and Handling
(continued)
• To dispose of medications, remove from container, mix with
undesirable substance such as pencil shavings or used coffee
grounds, and place in impermeable plastic sealable bag, crush all
pills, open capsules and add water to mix and create an
undesirable substance. Discard in trash as close to pickup day
and time as possible.
• Student information should be removed or concealed with
marker before discarding bottle or container.
20
Counting Pills
• Some pills require counting by 2 people
• Any controlled substance:
• Sedatives
• Stimulants
• Anti-convulsive
• Narcotic analgesics
• Pyschotropics
• May count with parent & staff or 2 staff members
21
DOCUMENTATION
• Documentation must be accurate, legible and completed at the
time of the administration.
• Document in blue or black ink only. No pencil.
• If you make a mistake in charting, cross out with a single line
and mark “ME” (mistaken entry), do not use white out.
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CONFIDENTIALITY
• Student medication files are confidential.
• Files should be locked with the medications
and access limited to authorized school staff.
• Parent written authorization is required for
release of information.
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MEDICATION RECORD
RETENTION
• Medication records should be filed at the end of the school
year. Place record in student’s health folder in the cumulative
file.
• If medication administration is related to an IEP, the
medication record is placed in the Special Education file for the
student.
28
MEDICATION ERRORS &
UNEXPECTED SITUATIONS
• Report medication errors immediately to the parent, building
administrator, and the school nurse.
• The following actions constitute an error:
Medication not given.
Medication administered to wrong student.
Wrong medication or wrong dose given to student.
Medication given at wrong time.
Medication given the wrong way or route.
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Medication Errors and Unexpected
Situations (continued)
• If student does not come for medication at scheduled time:
send for, document and notify parent.
• If student refuses medication: ask for reason, encourage,
document, notify parent and school nurse.
• If student vomits or spits out medication: document, notify
parent, send home if ill.
• All medication has the potential for side effects. Report any
unusual symptoms or behaviors to school nurse and parent
immediately.
30
STUDENT SELF-
ADMINISTRATION
• If a student is permitted to self-administer medications it means
no assistance and no documentation is necessary .
• To self-administer, the student must be able to demonstrate the
ability, both developmentally and behaviorally, to self medicate
with written permission from parent, and building
administrator, and physician if the medication is a prescription
medicine.
31
Student Self-Administration
(continued)
• Check with your school district for a self-administration policy
and written agreement for all parties to sign.
• This agreement may be revoked at any time if student unable to
comply with agreement.
32
FIELD TRIPS OR OFF CAMPUS
ACTIVITIES
• If any medication is to be administered when students are on a
field trip or off campus , a staff person trained in medication
administration must accompany the student group.
• Any/all medications taken on the activity must
be kept in their original container.
• Trained staff will sign the medications out and
then back and document administration upon return to
school.
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