ADMINISTRATION OF MEDICATIONS | Administrative Guideline Manual

5330 - ADMINISTRATION OF MEDICATIONS

For purposes of this guideline:

“Practitioner" means any physician, naturopathic doctor, dentist, optometrist, physician assistant, advanced practice nurse prescriber, or podiatrist licensed in any state.
'Medication' shall include all drugs including those prescribed by a practitioner and any nonprescription drug products.
Prescription Medication: A substance recognized as a drug defined in Wis. Stat. 450.01 (1)(10) (a-d). This statute defines drugs as: Any Substance recognized in the official U.S. Pharmacopoeia and national formulary of Homeopathic Pharmacopoeia of the U.S. or any supplemental publication of these references.
'Nonprescription drug product' means any non-narcotic drug product which may be sold without a prescription order and which is prepackaged for use by consumers and labeled in accordance with the requirements of State and Federal law.
Nonprescription drug products include cough drops that contain active ingredients. These cough drops must be handled in the same manner as aspirin, Advil and Tylenol. If a cough drop contains only sugar, water, and some menthol, the procedures for handling nonprescription drug products are not required.
'Administer' means the direct application of a nonprescription drug product or prescription drug, whether by injection, ingestion, or other means, to the human body.
Controlled Substances: Those drugs which are defined and regulated by the Uniform Controlled Substances Act of 1970.

Prescribed Medications

In those circumstances where a student must take prescribed medication during the school day, the following guidelines are to be observed:

Parents should determine with their practitioner’s counsel whether the medication schedule can be adjusted to avoid administering medication during school hours.
An acceptable authorization form must be filed with the school nurse before the student will be allowed to begin receiving any medication during school hours. Acceptable forms include: Food Allergy & Anaphylaxis Emergency Care Plan, Seizure Action Plan, School Asthma Care Plan, or other facimile. This written and signed request form is to be submitted on an annual basis, or more often if changes in dosage occur, and will include:
1. student's name and date of birth;
2. medication and dosage or procedure required;
3. times required;
4. special instructions including storage and sterility requirements;
5. date prescribed medication will be started;
6. date prescribed medication will no longer be needed;
7. practitioner's name, address, and telephone number;
8. probable side effects, including any already experienced by the student from the medication;
9. authorization for trained school personnel to administer the prescribed medication, with school authorization;
10. agreement to notify the school in writing if the medication, dosage, schedule, or procedure is changed or eliminated. A new request form must be submitted each school year or for each new medication.
For each prescribed medication, the medication shall be in the original pharmacy-labeled package with the following information in a legible format:
1. student’s name
2. practitioner’s name
3. date
4. pharmacy name and telephone
5. name of medication
6. prescribed dosage and frequency
7. special handling and storage directions
All medications to be administered during school hours must be registered with the nurse's office. Upon receipt of the medication, the health office attendent shall verify the amount of medication brought to the school and indicate that amount on the student's medication log sheet.
Medication that is brought to the office will be properly secured. Medication may be conveyed to school directly by the parent or transported by transportation personnel (bus driver and/or bus aide) at parental request. This should be arranged in advance. Two to four (2-4) weeks’ supply of medication is recommended. Medication MAY NOTbe sent to school in the student's lunch box, pocket, or other means on or about the student's person. An exception to this would be prescriptions for emergency medications.

Nonprescription Drug Products

In those circumstances where a student must take a Nonprescription Drug Product during the school day, the following guidelines are to be observed:

An acceptable authorization form must be filed with the school nurse before the student will be allowed to begin taking any medication during school hours.
For each nonprescription drug product, the container shall be the original manufacturer’s package and the package must list in a legible format the ingredients and recommended therapeutic dose.

The parents request to administer a nonprescription drug product shall contain the following information:
1. student's name
2. date
3. name of medication
4. dosage and frequency
5. special handling and storage directions
6. authorization for trained and authorized school staff to administer the medication
7. health care practitioner's note authorizing administering medication in a dosage that varies from the label's recommended dosage, if applicable

General Procedures

A Medications Administration Daily Log, either in digital or paper format, recording the administration of each prescribed medication and nonprescription drug product shall be maintained. The log will note the personnel giving the medication, the date, the exact dosage administered, and the time of day. The log will include each error in the administration of the medication and each missed administration of the medication. This log will be maintained along with the practitioner's written request and the parent's written release.
Written documentation of the Department of Public Instruction approved training provided for each person authorized to administer a prescribed medication or treatment will show:
1. what training was given;
2. the trainer’s name and professional status;
3. when the training was given.
Any unused medication unclaimed by the parent will be destroyed by administrative personnel when a prescription is no longer to be administered or within seven (7) days after the end of a school year. Medication must be disposed of in an approved manner, not by flushing medications. School personnel may contact law enforcement or local hospitals to identify locations for disposal of medications.
The staff member administering the medication shall make a reasonable effort to see that the student takes the medication properly.
If a student does not take the medication at the proper time, the staff member responsible for administering the medication shall take appropriate steps to locate the student and administer the medication and to then notify the parents of the importance of the child reporting on time for their medication.
All medications are to be administered in such a way as to protect the student's privacy.
A medication error includes any failure to administer medication as prescribed for a particular student, including failure to administer the medication within appropriate time frames, in the correct dosage, in accordance with accepted practice, and to the correct student. In the event of a medication error, the school nurse shall notify the parent(s) immediately. If there is a question of potential harm to the student, the school nurse shall also notify the student's practitioner.

The school nurse shall document medication errors on the Medications Log. The school nurse shall review reports of medication errors and provide consultation to ensure appropriate medication administration in the future.
Student with Severe Asthmatic Symptoms

Use of Metered Dose or Dry Powder Inhalers

Students with asthma may, while in school, at a school-sponsored activity, or under the supervision of a school authority, possess and use a metered dose inhaler or dry powder inhaler when the following three (3) conditions are met.
1. The student is required to carry an inhaler for use prior to physical activity to prevent the onset of asthmatic symptoms or for use to alleviate asthmatic symptoms; and
2. the completed Parent Consent form for a minor student has been submitted to the Principal; and
3. the practitioner's order for medication administration has been submitted to the Principal authorizing the student to possess and use an inhaler.

Students with asthma who are not required to carry an inhaler shall follow the guidelines which apply to all other prescription medications and their administration.

Students with Severe Allergic Reactions

Use of Epinephrine Auto-Injector

Students who may suffer from severe allergic reactions may, while in school, at a school-sponsored activity, or under the supervision of a school authority, possess and use an epinephrine auto-injector when three (3) conditions are met.
1. The student is required to carry the epinephrine auto-injector for use to prevent the onset of an allergic reaction; and
2. The completed Parent Consent form for a minor student has been submitted to the Principal; and
3. The practitioner's order for medication administration has been submitted to the Principal authorizing the student to possess and use the epinephrine auto-injector.

Students who are known to have severe allergic reactions but are not required to carry an epinephrine auto-injector shall follow the guidelines which apply to all other prescription medications and their administration.

Use of Epinephrine Auto-Injector by School Officials

The main office of each school shall obtain a prescription for the school to keep on hand at least two (2) epinephrine auto-injectors (both junior and regular) for use by trained and willing staff in the event of an anaphylactic emergency situation. The school nurse shall assure that staff are provided with training opportunities to both identify the symptoms of an anaphylaxis emergency and how to administer an epinephrine injection consistent with the approved plan adopted by the Board per Policy 5330 - Administration of Medication/Emergency Care. The school nurse shall assure that epinephrine stock is maintained and that unused expired pens are properly discarded and replaced. This is subject to the ability to obtain the epinephrine pens through prescription.

School personnel are not required to administer a nonprescription drug product or prescription drug by means other than ingestion. However, personnel designated to administer medications may indicate a willingness to provide medications, in an emergency or special situation, by means other than ingestion. This is done only upon completion of the training specified in the plan adopted per Policy 5330. The school nurse shall provide documentation that any designated school personnel approved to administer an epinephrine auto-injector has completed the requisite training.

A school nurse or designated school personnel authorized to administer an epinephrine auto-injector may do any of the following during the period of time that a standing protocol approved by a physician, physician assistant, or advanced practice nurse prescriber:

Provide one of the school's epinephrine auto-injectors to a student to self-administer consistent with a prescription specific to that student which is on file with the school.
Administer an epinephrine auto-injector to a student consistent with a prescription specific to that student which is on file with the school.
Administer an epinephrine auto-injector to a student who does not have a prescription on file with the school or to a student for whom the school nurse or designated school personnel does not know whether a prescription is on file if the following apply:
1. the school nurse or designated school personnel believes in good faith that the student is experiencing anaphylaxis;
2. the school nurse or designated school personnel contacts emergency medical services (911 or local equivalent) as soon as practicable after administration of the auto-injector

Use of Diphenhydramine (Benedryl)

Diphenhydramine will be used for significant but non-life-threatening allergic reactions.

Administer Diphenhydramine to a student consistent with a prescription specific to that student which is on file with the school.
Provide Diphenhydramine to a student that does not have a prescription on file with the school or to a student for whom the school nurse or designated school personnel does not know whether a prescription is on file if the following apply:
1. the school nurse or designated school personnel believes in good faith that the student is experiencing a non-life-threatening allergic reaction;
2. the school nurse or designated school personnel contacts the students parent/guardian as soon as practicable after administration of medication.

Administration of Opioid Antagonist

School bus operators, a school employee, or school volunteer may administer an opioid antagonist to a person who appears to be experiencing an opioid overdose under the following conditions:
1. the person has been authorized to administer such drugs, in writing, as required by Policy 5330; and
2. the person has received any training required for the administration of opioid antagonist in the form in which it is to be administered, consistent with the plan adopted pursuant to Policy 5330 in consultation with a registered nurse employed by or consulting with the District.
Nonprescription Drug Products

Students in grades 9-12 may be allowed to possess and self-administer a nonprescription drug product upon the written authorization of the parent. The parent must complete an acceptable authorization form and submit it to the school office.

If a student is found in possession of medication the student's record should be checked to determine if the proper authorization is on file. If not, the matter is to be reported to the Principal for possible disciplinary or other action. The Principal may take one or more of the following actions, depending on the particular situation:
1. Contact the parent and arrange for the parent to submit an acceptable authorization form as soon as possible.
2. Take the medication from the student and keep it in the school office until the completed form has been submitted.
Dispensing of nonauthorized, drug products by District employees to students served by the District is prohibited. Where investigation confirms such conduct, prompt corrective action shall be taken, up to and including dismissal.
To minimize health and safety risks to student-athletes and maintain ethical standards, school personnel, coaches, athletic trainers, and lay coaches should never dispense, supply or recommend the use of any drug, medication, or food supplement for performance-enhancing purposes.

School personnel trained to administer medications and authorized in writing by the Principal to administer drugs to students shall keep a copy of the Administration of Medication Policy and Guidelines in an accessible spot for quick reference and have the right to refuse to administer medication to students when the required authorization forms and signatures have not been completed.