Lewisburg Area School District Policies	Printable version
210 Use of Medications 210. USE OF MEDICATIONS The Lewisburg Area School District recognizes that parents/guardians have the primary responsibility for the health of their children. Although the district strongly recommends that medication be given in the home, it realizes that the health of some children requires that they receive medication while in school. Physicians should be made aware of the problems associate with giving medications in the school setting and arrange for medication to be administered before and/or after school hours whenever possible. When medication must be administered during school hours, the following procedure shall be followed in order to ensure student safety, to prevent mistakes, illegal acts or possible liability for the school district and its employees. For purposes of this policy, medication shall include all medicines prescribed by a licensed prescriber, any over-the-counter medicines, and vitamins and supplements. For the purposes of this policy, school nurse shall include registered nurses, licensed health room aides, and properly licensed substitute nurses. For purposes of this policy, licensed prescribers shall include licensed physicians (M.D. and D.O.), podiatrists, dentists, optometrists, certified registered nurse practitioners and physicians assistants. The Board directs all district employees to comply with the Pennsylvania Department of Health’s Guidelines for Pennsylvania Schools for the Administration of Medications and Emergency Care. Before any medication may be administered to or by any student during school hours, the Board shall require the written request of the parent/guardian, giving permission for such administration. All medications shall be administered by the Certified School Nurse, or in the absence of the Certified School Nurse by other licensed school health staff (RN, LPN), except as otherwise noted in this policy. In the event of an emergency, a district employee may administer medication when s/he believes, in good faith, that a student needs emergency care. The Certified School Nurse shall collaborate with parents/guardians, district administration, faculty and staff to develop an individualized healthcare plan to best meet the needs of individual students. The district shall inform all parents/guardians, students and staff about the policy and administrative regulations governing the administration of medications. All standing medication orders and parental consents shall be renewed at the beginning of each school year. Student health records shall be confidential and maintained in accordance with state and federal laws and regulations and the Department of Health Guidelines. Students may possess and use asthma inhalers and epinephrine auto-injectors when permitted in accordance with state law and Board policy. Administration Of Prescription And Nonprescription Medication During School Hours Only a written request signed by the parent/guardian accompanied by a medication order from a licensed prescriber containing the following will be accepted: 1. Date. 2. Child’s name. 3. Diagnosis. 4. Name of the medication. 5. Route and dosage of the medication. 6. Required administration time and frequency. 7. Termination date for administration of the medication. 8. Listing of all other medication being taken at present, both prescription and nonprescription. 9. Any restrictions on school activities. 10. Any particular condition or circumstances relating to this patient that should cause the school nurse not to administer the medication. 11. Any particular side effects relating to this patient that the school nurse and any school personnel should make special effort to inquire about or observe. 12. Physician’s phone number. 13. Physician’s signature. The initial dosage of the medication shall have been administered either at the student’s home, the physician’s office, or the hospital, except in the case of an emergency. In the case of an emergency, the initial dosage may be administered in school. Initial dosage refers to the first dosage administered from the prescription. All medication orders must be renewed each school year. Prior to the administration of any medication, the school nurse must verify that they are administering the right medication to the right student, in the right dosage and the right route at the right time. Any medication that is distributed during school hours must be documented in the student’s School Health Record. The following information must be included in this record: 1. Student name. 2. Date and time medication was given. 3. Name of medication. 4. Dosage. 5. Route and site of administration. 6. Signature of licensed person administering/observing medication being taken. 7. Where necessary in the opinion of the school nurse, results should be charted in order to document whether appropriate results are being obtained. Delivery Of Medication Any medication to be given during school hours must be delivered directly to the school nurse by the student’s parent(s)/guardian(s). The medication must be brought to school in the original pharmaceutically dispensed and properly labeled container and may not at any point be placed in any other container for storage. The primary care provider should issue a prescription to the pharmacist instructing the pharmacist to place all medications that should be taken during the school day in a separate and properly labeled prescription container from the portion of the medication that will be administered outside of the school day. Upon receipt, the school nurse will document the quantity of medication received, the date of receipt, and the time of receipt. This documentation shall be signed by both the school nurse and the parent/guardian delivering the medication. Under no circumstances shall the school nurse accept medications in plastic bags or any containers other than the original pharmacy container. Prior to the administration of any medication, the school nurse will ensure that the student who is to receive the medication has been positively identified so that no medication is administered to the wrong student. Consent forms for all prescription and non-prescription medication will be signed and accompany the medication. These consent forms must contain the parent’s/guardian’s printed name, signature, and an emergency contact phone number; a statement approving the school nurse or other licensed school health staff to administer medications; and a list of all other medications that the student is currently taking. These forms must also be accompanied by the Medication Order as described earlier in this policy. Personnel Responsible For Administration Of Medication The school nurse and the student’s teacher will collaborate in order to establish a process for the timely reporting of a student to the health suite for the administration of medication in accordance with this policy. The school nurse will be responsible for administering or supervising the self-administration of all medication. A medication log will be kept on any student receiving any medication, including but not limited to prescription, stocked, and prescribed nonstocked medication during school hours. Supply Of Medication For all illnesses, whether short-term, long-term, or a daily medication, no more than a four-week supply of medication may be brought to the school nurse for administration during school hours. A written re-authorization will be required from the parent/guardian and the prescribing physician on the first day of each school term for all long-term or daily dosage medications. For short term illnesses, after the expiration of the medication order, a new written request and medication order will be required before any medication will be administered. Storage Of Medication Prescription medication will be kept in a locked storage unit in the nurse’s office in the school’s health room. All prescription medications will be stored in their original pharmacy container. Access to medications is limited to the school nurse and any other licensed professionals, except in the case of a life-threatening emergency. Disposal Of Medications Procedures shall be developed for the disposal of medications consistent with the Department of Health Guidelines, which shall include: 1. Guidelines for disposal of contaminated needles or other contaminated sharp materials immediately in an appropriately labeled, puncture resistant container. 2. Processes for immediately returning to parents/guardians all discontinued and outdated medications, as well as all unused medications at the end of the school year. 3. Methods for safe and environmentally friendly disposal of medications. 4. Proper documentation of all medications returned to parents/guardians and for all medications disposed of by the Certified School Nurse or other licensed school health staff. Documentation shall include, but not be limited to, date, time, amount of medication and appropriate signatures. Stocked Medication Stocked medication consists of over-the-counter medication that is both maintained by the district and is covered by the school physician’s standing order. All medication that is not stocked by the district must comply with all of the requirements set forth in this policy, including the requirement that all such medications be accompanied by a valid physician’s prescription. In accordance with the school physician’s standing order, subject to change as the school physician so advises the district shall stock the following medications. 1. Acetaminophen. 2. Ibuprofen. 3. Cough drops. 4. Antacids. 5. Throat Lozenges. 6. Epinephrine (for anaphylactic reaction). 7. First aid cream or triple antibiotic ointment. 8. One percent (1%) hydrocortisone cream. 9. Orthodontic numbing agent. A parent/guardian must authorize the administration of the medications listed above by indicating their consent on the health update form required by the district. A new health update form must be signed each year. This listing will be updated yearly through the parental consent form for the administration of stocked medication. The school nurse may require an order from a private physician for any stocked medication if in the nurse’s discretion it is determined that a student is requesting a medication on a continuous and regular basis for the same complaint in order to ensure that his or her healthcare provider has assessed the student. Other Guidelines For All Medications The parent/guardian of the child must inform the school nurse of any change in the child’s health or change in medication varying from the original written instructions. Any change in medication which varies from the original physician’s order must be accompanied by a new and complete physician’s order. In the event the following specific requirements are not met, the school district retains the discretion to reject requests for administering medications: 1. Requirement for written authorization by legal parent. 2. Requirement for written authorization by prescribing physician. 3. Requirement that medication be delivered to the school in its original labeled container. 4. Requirement for written indication that initial dosage has been administered either at home, the physician’s office, or the hospital except in life-threatening emergency situations. 5. For long-term medication, written re-authorization by parent/guardian and prescribing physician shall be received in school on the first day of each school term. Emergency Medications Under Pennsylvania law, any officer or employee of a school who in good faith believes that a student needs emergency care, first aid or rescue and who provides such emergency care, first aid or rescue shall be immune from civil liability as a result of any acts or omissions by the officer or employee, except any acts or omissions intentionally designed to seriously harm or any grossly negligent acts or omissions which result in serious bodily harm. Students may self-administer emergency medication in school when they have the authorization of a licensed prescriber, their parent/guardian, and the district. Prior to permitting a student to self-administer, the school nurse will perform a baseline assessment of the student’s health status; ensure that the student is competent in self-care through the demonstration of the skills necessary for proper administration of the medication and responsible behavior regarding same; and engage in periodic and ongoing assessment of the student’s self-management skills. The student will be required to notify the school nurse immediately following each self-administration. The medication will be confiscated and the student will lose self-administration privileges if this policy is abused or ignored. Immediate Use Medications For Certain Conditions Students who have medical conditions that require immediate medications (such as but not limited to asthma inhalers, emergency allergy medications, and diabetic treatment) that have a written order from the prescribing physician to carry such medications, shall be permitted to carry the authorized medication on their person. The school nurse and the student will determine an appropriate location for self-administration when it occurs on school property. Names of students authorized to self-medicate shall be distributed to coaches and appropriate staff. Students may not carry unauthorized medications on their person or have them in their desks, lockers, or personal belongings. Field Trips In the event of a field trip, overnight trip, or other special events where a nurse is not present to administer medications, the student shall be responsible for self-administering his/her medication. In such instances a parent will be required to complete a Self-Administration of Medication Authorization form that must also receive the approval of the school nurse. A parent/guardian will provide a properly labeled, original container with only the amount of medication that will be needed during the field trip. The school nurse shall approve self-administration forms when the nurse is satisfied that the student is competent and responsible enough to self-administer the prescribed medication. All other rules regarding prescription medications and over-the-counter medications continue to apply. Policy Distribution A copy of this policy will be provided to parents/guardians upon request. References: School Code – 24 P.S. Sec. 510, 1401, 1402, 1409, 1414.1 State Board of Education Regulations – 22 PA Code Sec. 12.41 Civil Immunity of School Officers or Employees Relating to Emergency Care, First Aid or Rescue – 42 Pa. C.S.A. Sec. 8337.1 Pennsylvania Department of Health “Guidelines for Pennsylvania Schools for the Administration of Medications and Emergency Care” March 2010 Board Policy – 000, 103.1, 113, 121, 210.1, 216