JLCD – Administration of Medication in Schools

The ConVal School Board, with the advice of the ConVal professional registered nurses (herein referred to as the school nurse) shall establish specific policies and procedures to give protection and controls to the matter of medications in schools (Ed 311.02)(JLCD-R).

The intent of this policy is to provide general standards for the administration of necessary medication to students during school hours and school-sponsored activities.

The following policy will be adhered to when a student requires medication administration during school hours and scheduled school-sponsored activities, events or programs. In addition, the school nurse and principal are responsible for ensuring the provisions of Ed. 311.02, Medication During the School Day, are followed.

Obligations of the District

 All medication to be administered shall be kept in a securely-locked cabinet. Controlled medications must be double-locked. If at any time the cabinet is broken into resulting in missing medication, school administration and the police will be notified immediately. The parent/guardian/adult student will be notified of the incident and must replenish the supply of medication.

If the school nurse is not available, the building principal or the principal’s designee is permitted to assist students in taking required medications by: (1) making such medications available to the student as needed; and (2) observing the student as he/she takes or does not take his/her medication; and (3) recording whether the student did or did not take his/her medication.

The school nurse will maintain all necessary records relative to the emergency administration of medication and will file all such reports as may be required.

The School Board hereby authorizes the school nurse to maintain a supply of emergency medications, i.e.; bronchodilators and epinephrine.

It is the policy of this District that its school nurses and all Health Office Delegatees (HODs) shall be properly trained in the administration of medication in a manner consistent with this policy. HODs shall be trained on an annual basis and the school nurse shall document that training to the Director of Student Services. The HOD shall hold and maintain current American Heart Association or American Red Cross CPR/AED/FA Adult and Child certification. This training shall include a practicum.

School personnel shall not provide his/her personal medication to students.

Obligations of the School Nurse

Only the school nurse or the HOD may administer medication. If the student requires a comprehensive nursing assessment and/or evaluation, this must be done by the school nurse and cannot be delegated. A school nurse alone has the authority to delegate medication administration and may delegate only if appropriate under the Nurse Practice Act and follows the Standards of Delegation for School Nurses in New Hampshire.

The School Nurse may stock epinephrine in the Health Office per RSA 318:42 for the emergency treatment of anaphylaxis of a student, as determined by the school nurse.

Storage of Medication

It is the policy of the District that all medications, both school, and parent-provided, shall be securely and properly stored, in a manner consistent with all applicable laws, as well as safe and prudent school nursing practices.

At the discretion of the school nurse, other medications, such as insulin, may be carried and self-administered by the student.

A single dose of medication may be transferred by the school nurse from the original container to a newly labeled container for the purposes of field trips or school sponsored activities.

Verbal orders from a licensed health care provider may be accepted by the school nurse only and shall be followed with a written order. Faxed or e-mailed orders are acceptable.

The school nurse is responsible for keeping accurate records regarding the administration of medication to students. The school nurse shall maintain medication records of inventory, storage and administration in accord with ED 311.02 (Medication During the School Day).

Obligations of the Parent/Guardian/Adult Student

Prescribed/OTC (over the counter) medication should not be taken during the school day, if at all possible, to achieve the medical regime during hours at home.

A parent/guardian/adult student, or their designated responsible adult, shall deliver all medication to be administered by school personnel to the school nurse or other responsible person designated by the school nurse as follows: (1) the prescription/OTC medication shall be delivered and kept in a pharmacy or manufacturer labeled container (2) the school nurse or principal’s designee receiving the prescription medication shall document the quantity of the prescription medication delivered and have the adult delivering the medication co-sign the documented amount (3) the medication may be delivered by the parent/guardian/adult student or a designated adult, provided that the nurse is notified in advance by the parent/guardian/adult student of the delivery and the quantity of prescription medication being delivered to school is specified (4) the parent/guardian/adult student must ensure that the life-saving medication (Diastat, asthma metered dose inhalers, Epi-Pen, Glucagon) or any other emergency medication be available to the student at all times. If the student’s life-saving medication is not provided by the parent/guardian/adult student, the student shall not be permitted to attend any school-sponsored activities (5) it is the responsibility of the parent/guardian/adult student to notify the health office of any changes in student health, allergy status or medication changes.

Students requiring prescription medication administration must have a ConVal District medication permission form completed by parent/guardian/adult student and a licensed health care provider and placed on file in the health office. The forms shall comply with standards set forth in NH Code of Administrative Rules Section Ed 311.02. The school nurse, with written authorization of parent/guardian/adult student shall administer non-prescription/OTC medication. At the discretion of the school nurse, a written licensed prescriber’s order may be required. If the school nurse is not available and written parent/guardian/adult student permission is on file, the principal or principal’s designee is permitted to assist students in taking OTCs after consultation with the parent/guardian.

Furthermore, any student with a health condition requiring treatment with herbals, homeopathics, essential oils, or other complementary forms of therapeutic interventions shall have a school medication permission form completed by the parent/guardian/adult student as well as a licensed healthcare provider.

Alternative medications should, whenever practicable, be taken at home.  Parents/guardians should inform the school nurse of any such alternative medications.  The school nurse shall not administer alternative medications, such as herbal medication, homeopathic medication, essential oils, or other similar forms of alternative medication unless the parent/guardian/adult student has completed and placed on file in the school health office a school medication permission form naming the specific alternative medicine and providing evidence that is has been prescribed by a licensed prescriber.  The School Nurse shall not administer an alternative medicine that is prohibited by State or Federal law, or which is unlawful to possess in school.

Students may possess and self-administer a metered dose inhaler or a dry powder inhaler to alleviate or prevent asthmatic symptoms, an auto-injector for severe allergic reactions, and other injectable medications necessary to treat life-threatening conditions. The parent/guardian/adult student and physician must authorize such self-possession and self-administration by completing a school self-administration form in accordance with RSA 200:42 and RSA 200:46. Inhalers and epinephrine auto injectors must be properly labeled with the student’s name and type of medication. The student will be held responsible to keep self-carried medication in a safe place that is not accessible to other students. When a student finds it necessary to use his/her auto-injector, s/he shall immediately report it to the nearest supervising adult.

Students shall not share any prescription or over-the-counter medication with another student. Notice of this prohibition shall be published in student handbooks. Students acting in violation of this prohibition will be referred to school administration and may be subject to discipline consistent with applicable Board policies (JICH — Drug and Alcohol Use By Students, JIH – Student Searches and Their Property).

Student medications may be retrieved from the health office by the parent/guardian/adult student or a designated adult at any time during regular school hours. Medication will be discarded if not picked up within 10 days after the medication is discontinued.  All medication must be picked up by the last day of school or it will be discarded.

Civil Immunity

Nothing set forth in this policy or JLCD-R shall be deemed to abrogate or diminish the civil immunity available under New Hampshire law or either the District or its employees.

Definitions

The “school day” means any time during the day, afternoon, or evening when a child is attending school or other school-sponsored activity (Ed 311.02).

Health Office Designee (HOD) (school nurse delegatee) – unlicensed assistive personnel – receives annual training by a school nurse.

Assist – Consists of providing the medication to the student and observing and documenting that the student took the medication.

Administration – Giving medication to the student via the appropriately ordered route by preparing, giving and evaluating the effectiveness of prescription and non-prescription drugs. If the student is unable to administer the medication to his/her self, with assistance, only the school nurse or HOD may administer the medication.

Legal References:

 RSA 200:42, Possession and Use of Epinephrine Auto-Injectors Permitted

RSA 200:43, Use of Epinephrine Auto-Injector

RSA 200:44, Availability of Epinephrine Auto-Injector

RSA 200:44-a, Anaphylaxis Training Required

RSA 200:45, Student Use of Epinephrine Auto-Injectors – Immunity

RSA 200:46, Possession and Self-Administration of Asthma Inhalers Permitted

RSA 200:47, Use of Asthma Medications by Students – Immunity

RSA 200:53, Bronchodilators, spacers, and nebulizers in schools

RSA 200:54, Supply of Bronchodilators, Spacers or Nebulizers

RSA 200:55, Administration of Bronchodilator, Space or Nebulizer

RSA 318:42, Dealing in or possessing prescription drugs (VII-b)

N.H. Code of Administrative Rules – Section Ed. 306.12(b)(2), Special Physical Health

                        Needs of Students

N.H. Code of Administrative Rules – Section Ed. 311.02(d); Medication During School Day

NH Board of Nursing-Nurse Practice Act – www.nh.gov/nursing/nurse-practice-act/

Standards of Delegation for School Nurses in New Hampshire

Category:  P – Required by Law

See also:  JICH, JIH, JLCD-R, JLCE

First Read:  November 21, 2017

Second Read:  December 5, 2017

Adopted:  December 5, 2017