Each school principal, in consultation with the school Registered Nurse (RN), will authorize two staff members to administer medications including over the counter (OTC) medications. These designated staff members will receive delegation and training prior to administering the first dose and they will receive ongoing RN supervision
For purposes of this procedure, “medication” means oral medication, topical medication), eye drops, ear drops and nasal spray. This definition does not include OTC topical sunscreen products regulated by the US Food and Drug Administration (see sunscreen section below). Oral medications are administered by mouth either by swallowing or by inhaling and may include administration by mask if the mask covers the mouth or mouth and nose.
Medication may be dispensed to students on a scheduled basis upon written request from a parent with a written request by a licensed health professional (LHP) prescribing within the scope of their prescriptive authority. If the medication is to be administered more than 15 consecutive days the written request must be accompanied by written instructions from a LHP. Requests will be valid for not more than the current school year. All new orders for medication or medication order changes must be approved by the supervising RN prior to school staff administering the first dose.
All medications must be properly labeled and be contained in the original container. Individuals administeringmedications will:
- Collect the medication directly from the parent/guardian (students should not transport medication to and from school except for medications needed for the treatment of medical emergencies), collect an authorization form properly signed by the parent/guardian and by the LHP including instructions from the LHP if the medication is to be administered for more than 15 consecutive days;
- Count the medication and record the number pills or amount of liquid medication received, with initials and date received, on the medication log. It is preferable to have two people count and initial; Counting of controlled substances at least weekly as recommended by the Board of Pharmacy. On weekly medication counts, the nurse must have assistance and a witness to the actual count of the medications.
- Store the prescription or OTC medication (not more than a twenty 20 day supply) in a locked, substantially constructed cabinet; or limited access area (for emergency medications);
- Maintain a current record which indicates that the medication was administered. If a dose is missed, note the reason, e.g., “absent.” This record must be kept for eight years;
- Medications may not be given after the date specified on the authorization form or expiration date on the label.
- Report medication errors to the school nurse immediately.
Provide for supervision by a physician or a RN. A copy of the medication policy will be provided to the parent/guardian upon request.
Oral or topical medications, eye drops, ear drops, or nasal spray may be administered by a RN, a licensed practical nurse (LPN) or designated staff who are delegated to, trained, and supervised by the RN.
Nasal sprays containing controlled substances may only be administered by a school nurse if a school nurse is in the building. If a school nurse is not in the building, the task may be delegated to an authorized school employee. A parent-designated adult (PDA) with training as required by RCW 28A.210.260[AH1] may also administer the medication when the school nurse is not in the building. After a school employee who is not a school nurse administers a nasal spray that is a controlled substance, the employee must summon emergency medical assistance as soon as practicable except in instances when the administration of the nasal spray occurs routinely as documented in emergency care plan signed by parent or guardian and LHP.
No prescribed medication will be administered by injection by staff except when a student is susceptible to a life-threatening anaphylactic condition consistent with Policy and Procedure 3419 Self-Administration of Asthma and Anaphylaxis Medications and Policy and Procedure 3420 Anaphylaxis Prevention and Response, when acting as a PDA for students with diabetes consistent with Policy and Procedure 3415 Accommodating Students with Diabetes, or when acting as designated trained responder for opioid overdose reversal medication administration consistent with Policy and Procedure 3424 Opioid Related Overdose Reversal situation.
The parent/guardian will submit a written authorization to act according to the specific written orders and supporting directions provided by the LHP prescribing within their prescriptive authority (e.g. medication administered to counteract a reaction to an insect sting). Such medication will be administered by staff trained by the supervising RN to administer such an injection.
Written orders for emergency medication, signed and dated, from the LHP prescribing within their prescriptive authority will:
- State that the student has a health condition that may result in an emergency;
- Identify the drug, the mode of administration, and the dose.
- Indicate when the medication will be administered based on anticipated or actual symptoms
- Recommend follow-up after administration, administration of additional medications, transport to hospital; and
- Specify how to report to the LHP prescribing within their prescriptive authority and any record keeping recommendations.
If a health professional and a student’s parent/guardian request that a student be permitted to carry their own medication and/or be permitted to self-administer the medication, the principal may grant permission after consulting with the school nurse. The process for requesting and providing instructions will be the same as established for oral medications. The principal and nurse will take into account the age, maturity and capability of the student; the nature of the medication; the circumstances under which the student will or may have to self-administer the medication and other issues relevant in the specific case before authorizing a student to carry and/or self-administer medication at school. Except in the case of multi-dose devices (like asthma inhalers), students will only carry one day’s supply of medication at a time. Violations of any conditions placed on the student permitted to carry and/or self-administer his or her own medication may result in termination of that permission, as well as the imposition of discipline when appropriate.
Sunscreen
Over-the-counter topical sunscreen products may be possessed and used by students, parents, and school staff, without a written prescription or note from a licensed health care provider, if the following conditions are met:
- The product is regulated by the US Food and Drug Administration as an over-the-counter sunscreen product; and
- If possessed by a student, the product is provided to the student by their parent or guardian.
Students who possess over-the-counter topical sunscreen products that meet the above criteria may carry up to eight ounces at a time, preferably with the container in a plastic bag.
Violations of any conditions placed on the student permitted to carry and/or self-administer his or her own sunscreen products may result in confiscation and termination of that permission, as well as the imposition of discipline when appropriate.
School staff may assist students in application of sunscreen products in certain circumstances and in the presence of another staff member. The appropriate staff member will take into account the age, maturity, and capability of the student, the need for the application of the sunscreen, and other issues relevant in the specific case, before assisting students in application of sunscreen products at school or during school-sponsored events. However, staff members are not required to assist students in applying sunscreen.
Parent-Designated Adult Care of Students with Epilepsy or Diabetes
The policy and procedure for parent designated adults caring for students with epilepsy or students with diabetes is:
- 3411Accommodating Students with Seizure Disorders or Epilepsy
- 3415 Accommodating Students with Diabetes