BELLINGHAM SCHOOL DISTRICT 501

3416P

ADMINISTRATIVE PROCEDURE

ORAL MEDICATION AT SCHOOL

The district is authorized by RCW 28A.210.260-270 and RCW 18.71.030 (3) to administer prescribed oral medication to students during school hours or while students are in the custody of the district. The district will authorize its employees to administer prescribed oral medication to students only when the student requires such medication in order to attend school, school-sponsored activities, or when the student is susceptible to a predetermined life-endangering situation.

A.   DEFINITIONS:

1. “Prescribed oral medication” means all prescribed or over-the-counter oral medication dispensed to students on a scheduled basis upon written authorization from a parent and accompanied by written instructions from a licensed health care provider (LHCP): Physician, Dentist, Nurse Practitioner, Physician Assistant or Naturopath.
2. “Licensed professional” means a registered professional school nurse licensed pursuant to Chapter 18.88 RCW and employed by the district.
3. “Designated personnel” means those district employees described in Section B below.
4. “Parent” means parent, legal guardian, or other person having legal control over the student.

B.   DESIGNATED PERSONNEL:

The building principal in consultation with the school nurse shall annually designate staff members who are to administer prescribed oral medication. The names of the individual will be reviewed with the school nurse annually.

The principal or school nurse may request that additional staff members be authorized to administer prescribed oral medication throughout the year. These requests will be reviewed with the school nurse and the Director of Student Services.

Staff designated to administer prescribed oral medications in a specific situation (i.e.: on field trips and school sponsored activities outside of the regular school day) may only administer such medication within the specific situation. They may not administer medications to students at any other time.

Only employees of the district may be designated to dispense medications.

C.   TRAINING AND SUPERVISION:

The district's school nurses shall, under the general direction of the Director of Student Services, train and supervise designated personnel in the proper administration of prescribed oral medication. Only designated personnel who have received such training and licensed professionals shall administer prescribed medication.

The training of designated personnel in the proper administration of prescribed oral medication shall occur prior to assuming these responsibilities. In the following years, designated personnel shall receive annual re-training by a school nurse.

The district's school nurses shall also provide training and supervision to those staff authorized to administer prescribed oral medication in specific situations.

The district's school nurses shall supervise designated personnel by conducting periodic reviews of medication administration procedures.

D.   PARENT/LEGAL GUARDIAN AND LHCP REQUESTS AND INSTRUCTIONS:

Designated personnel shall administer prescribed medications to students only when the district has received:

1. Parent/legal guardian request and instructions:
   • Such request must be made in writing on the district medication form. The request must be current and unexpired.
   • The request must be signed by a parent.
2. LHCP requests and instructions:
   • The request must be made in writing by the student's LHCP on the district medication form. The request must be current and unexpired.
   • The request must be signed by the student's LHCP.
   • The request must state that a valid health reason exists which makes administration of the prescribed oral medication advisable during school hours or during such time that the student is under the supervision of school officials.
   • Written, clear, legible, current, and unexpired instructions must be obtained from the student's current LHCP regarding the administration of prescribed oral medication for students. These instructions must be non-discretionary.
   • BOTH THE REQUEST FOR ADMINISTRATION OF MEDICATION AS WELL AS THE WRITTEN INSTRUCTIONS FROM THE LHCP MUST BE RECEIVED BY THE SCHOOL PRIOR TO THE DELIVERY OF MEDICATION.
3. Medication:
   • The medication must be furnished in the current original container from the pharmacy with the student's name, the name of the medication, dosage, and the amount to be given. Non-prescription medication must be furnished in the original container from the manufacturer.
   • All medications must be in a form ready to be administered and must not require any preparation by the designated personnel.
   • It is the parent's responsibility to deliver and maintain an adequate supply (not more than one month's supply) of the medication at school. The child or school bus driver may not deliver the medication.
4. Dosage changes:
   • If there is a need to change the student's dosage and/or time of administration, the LHCP must submit a new request on a district medication form, A newly labeled container from the pharmacy indicating the new dosage and/or time is also required.
5. Self-Medication:
   • If the LHCP and parent believe that it is in the best interest of a student in grades 6 - 12 to self-medicate at school, they shall complete an “Authorization for Self Administration of Oral Medication at School.”
   • The original of this form, signed by the LHCP and parent will be kept on file in the school and must be returned PRIOR to the student initiating self-medication.
   • If a request for self-medication is received for a student in grades other than 6-12, the LHCP, parent and school nurse shall concur that the student is able to safely carry and administer medication.
   • Except in the case of multi-dose devices (like asthma inhalers), any student who is authorized to medicate themselves at school shall carry only one day's dosage of the medication in the current original container.
   • The medication must be furnished in a current original container from the pharmacy with the student's name, the name of the medication, dosage and the amount to be given. Non-prescription medication must be furnished in the original container from the manufacturer.
   • The district will assume no responsibility or liability for the administration of the medication should a student medicate himself or herself at school or at school sponsored activities.
   • Any violation of the Bellingham School District 3200 illegal drugs, alcohol/tobacco policy or the medication policy and procedures will result in corrective actions as outlined in the 3200 policy and procedures. A violation will also result in notification of the parent, LHCP and self-administration privileges will be revoked.

E.   PROCEDURES FOR ADMINISTRATION OF PRESCRIBED MEDICATION:

In addition to compliance with all other requirements set forth in this procedure, designated personnel shall:

1. Administer prescribed oral medication in substantial compliance with the written instructions of the student's LHCP. This shall include, but not be limited to, administration of medication no earlier than one-half hour before nor later than one-half hour after the time designated by the health professional. It is the student's responsibility to come and receive his/her medication at the appointed time.
2. Examine the prescribed oral medication before administration to determine if it appears to be in the original container and is properly labeled.
3. Keep an accurate record of all prescribed oral medication using district recording forms.
4. Follow hygienic practices when administering any medication (e.g., direct handling of oral medication should be avoided).
5. At the end of the year it is the parent's responsibility to pick up unused medication. Any medication left longer than 5 working days after the end of school, will be destroyed. The school nurse shall provide general direction to the designated personnel on the most appropriate way to destroy the medications. In every case, the oral medication shall be:
   • Destroyed by one of the individuals authorized to administer oral medications.
   • Witnessed by another member of the building staff.
   • Documented using an appropriate district form, which shall be maintained in the school office.

F.   MEDICATION ERROR:

In the event there is an error in administration (time, dose, medication, student) the staff member who administered the medication shall immediately call the school nurse assigned to the building. They shall collaboratively decide what action shall be taken.

Both the employee and the school nurse shall complete a Medication Incident Report documenting the error that occurred, the action taken by the school, the persons contacted as well as recommendations to prevent such an error from occurring in the future. A copy of the report shall be kept in the building and a copy sent to the Director of Student Services.

In every instance of mediation error, the student's parents and the building administrator will be notified.

G.   SAFEKEEPING OF PRESCRIBED ORAL MEDICATION:

Designated personnel shall assure safekeeping of prescribed oral medication by:

1. Keeping all medication in the original container;
2. Storing the medication in an appropriately sized, secured, and locked cabinet located in the school office area; and
3. Keeping no more than a one-month supply of such medication at school at one time.

Only designated personnel shall have access to a school's medicine storage cabinets.

H.   STUDENT RESPONSIBILITY:

It is primarily the student's responsibility to come and receive his/her medication at the appointed time. If this is not done on a regular basis, the nurse will review the administration procedure, and options will be considered.

I.   DISCONTINUANCE OF MEDICINE:

1. LHCP authorizations will automatically expire at the end of the school year and are subject to renewal in the succeeding year.
2. The chief administrator of the school district or his/her designee must provide notice, orally or in writing, in advance of the date of discontinuance.
3. Such notice shall be made to the parent, legal guardian, or other person having legal
4. control over the student.
5. There must be a valid reason, one which does not compromise the health of the student, to discontinue medication administration at school for any student.

J.   SPECIFIC SITUATIONS/FIELD TRIPS:

Designated staff will receive annual training by the school nurse that allows them to administer oral and emergency medications on field trips. Designated staff will give the office at least 24 hour notice to get authorization form and medication prepared. Specifically the following must be assured:

1. availability of designated personnel;
2. proper security and storage for the medication;
3. a copy of the health professional directions;
4. an appropriately labeled container; and
5. the appropriate dosage;
6. documentation on form, Written Record for Dispensing Medication.

K.   RECORDS RETENTION:

Individual student medication forms, both the Authorization for Administration of Medication and the Authorization for Self-Medication, as well as the Medication Administration Daily Log shall be maintained in the student's cumulative file for at least 8 years after the last dose authorized by the form.

Approved:

Dale E. Kinsley                                                                                                             June 26, 2003

Superintendent of Schools

Return to Table of Contents