Medication Administration Refresher
Jamie Smith RN, BSN
District Nurse
Jefferson County School District 509J
Madras, Oregon
(Thanks to Sue Morgan RN for her technical expertise in the development of this PowerPoint)
Medication Administration Refresher
Medication Administration Refresher
All medication taken in school must have written instructions
Documentation required for:
Non Prescription Medication: Requires written instructions from the parent that includes the name of the student, name of the medication, route of administration, dosage, frequency and time of administration, and special instructions.
All medication taken in school must have written instructions
Documentation required for:
Prescription Medication: Requires parental written instructions as stated above AND written instructions from the physician (the prescription label meets this criteria).
All medication taken in school must have written instructions
Documentation required for:
Prescription Medication: Requires parental written instructions as stated above AND written instructions from the physician (the prescription label meets this criteria).
The Physician instructions and the parent instructions MUST match. (Otherwise, how do you know which instructions are correct?)
All medication taken in school must have written instructions
Documentation required for:
Prescription Medication: Requires parental written instructions as stated above AND written instructions from the physician (the prescription label meets this criteria).
What is considered medication?
*Non Prescription: Commercially prepared, non-alcohol based medication necessary for the student to remain in school. This includes medication for the eyes, nose, cough drops, cough suppressants, analgesics (pain relievers), decongestants, antihistamines, topical antibiotics, anti-inflammatory medications, and antacids.
*Per OAR 581-021-0037
What is considered medication?
*Prescription: Any non-injectable drugs, chemical compounds, suspensions or preparations which are taken either internally or externally by a student under the instructions of a physician, prepared and labeled by a pharmacist at the discretion of a physician. It is only given at school if the prescribed frequency requires it to be given during school hours.
*Per OAR 581-021-0037
Check for Understanding:
Which of the following are not included in the definition of a medication (thus they may be given to a student without written authorization from the parent?)
Check for Understanding:
Which of the following are not considered to be a medication (thus they may be given to a student without written authorization from the parent?)
None of the above
Absolutely everything is considered a medication according to the law, and must have written authorization from the parent before we may administer it to a student.
What about �Self-Administered Medication?
K-8: No medication may be self-administered unless it is required for immediate emergency access such as insulin and asthma inhalers.
What about �Self-Administered Medication?
K-8: No medication may be self-administered unless it is required for immediate emergency access such as insulin and asthma inhalers.
9-12: Medication may be staff or self-administered.
What about �Self-Administered Medication?
All Students K-12
Before ANY medication may be self-administered, a medication authorization and self-administration agreement must be signed by the parent, student, administrator and the physician.*
*Physician authorization required for prescription medications only.
5 “Rights” of �Medication Administration
Right Student
5 “Rights” of �Medication Administration
Right Student
Right Medication
5 “Rights” of �Medication Administration
Right Student
Right Medication
Right Dose
5 “Rights” of �Medication Administration
Right Student
Right Medication
Right Dose
Right Time
5 “Rights” of �Medication Administration
Right Student
Right Medication
Right Dose
Right Time
Right Route
5 Rights of �Medication Administration
Right Student/Right Medication/Right Dose
Tips:
Double and Triple-check the prescription label with the parent instructions, the name of the medication, the correct student, and the correct dosage prior to administering the medication.
5 Rights of �Medication Administration
Right Student/Right Medication/Right Dose
Tips:
Double and Triple-check the prescription label with the parent instructions, the name of the medication, the correct student, and the correct dosage prior to administering the medication.
Do not administer medication while being distracted. Keep your focus solely on medication administration while in the process. Attend to other issues once the medication has been given.
5 Rights of �Medication Administration
Right Dose, continued
5 Rights of �Medication Administration
Right Dose, continued
5 Rights of �Medication Administration
Right Time
5 Rights of �Medication Administration
Right Time
5 Rights of �Medication Administration
Right Route….
… means the route that was ordered, such as:
5 Rights of �Medication Administration
Any violation of these 5 “rights” is a medication error. (Right student, medication, dose, time and route)
5 Rights of �Medication Administration
Any violation of these 5 “rights” is a medication error. (Right student, medication, dose, time and route)
If an error occurs, complete a Medication Incident Report, which you may receive from your building secretary or health assistant. Notify the parent and the school nurse.
Check for Understanding:
It is 9:30 and Johnny is bouncing off the walls. You ask Johnny if he had his morning dose of Ritalin before he left for school and he says no. Since he receives Ritalin at school, you ask the secretary or health assistant to give his morning dose that he missed.
Is this an appropriate request? Why or why not?
Answer:
No. Giving a dose that was forgotten at home is a “verbal change” to our written instructions. (The dose is a home dose, not a school dose).
Answer:
No. Giving a dose that was forgotten at home is a “verbal change” to our written instructions. (The dose is a home dose, not a school dose).
All medication given at school must have instructions and authorization provided in writing. (Our written instructions are for the later dose only).
Answer:
No. Giving a dose that was forgotten at home is a “verbal change” to our written instructions. (The dose is a home dose, not a school dose).
All medication given at school must have instructions and authorization provided in writing. (Our written instructions are for the later dose only).
The parent may come to school and give the medication, or they may fax a written request for the school to give the dose in question, but we may NOT give the extra dose without written instructions to do so.
Field Trips
Storage and Handling:
Field Trips
Storage and Handling:
We may not put medication into a plastic bag and label the bag. (Only a pharmacist may “dispense” medication, which means moving it from one container to another and then re-labeling it).
Field Trips
Storage and Handling:
Field Trips
Storage and Handling - continued:
Field Trips
Storage and Handling - continued:
Field Trips
Storage and Handling - continued:
Field Trips
Storage and Handling - continued:
Documentation
Sign out medication in the office.
Documentation
Sign out medication in the office.
All sedatives, stimulants, anti-convulsants, narcotic analgesics, or psychotropic medications
must be counted in the presence
of a witness, and both people must
sign the medication record to
document the count. (Your building
Health Assistant or Secretary will know
which medications need to be counted.)
Documentation
When you return:
(count again as you did
when you signed it out.)
was given on the medication
documentation form.
Documentation
Documentation
Documentation
Documentation
Something must be documented in each square where medication is to be recorded. If a student did not receive a medication, use the proper code as to why (absent, no medication available, etc.)
*Note: The line is drawn through the square on non-school days. Codes used in the picture are: A=Absent, N=No Med, initials mean the med was given. Other codes are listed at the top of the medication form. There are no blank squares.
Documentation
Remember…..
“If it wasn’t documented…it wasn’t done.”
This is how a court would view it.
Overnight Field Trips
Overnight Field Trips
Overnight Field Trips
Overnight Field Trips, continued
Overnight Field Trips, continued
Overnight Field Trips, continued
Overnight Field Trips, continued
Overnight Field Trips, continued
Confidentiality
Confidentiality
Confidentiality
Check for understanding
1. T F The correct time to give a medication is 30 minutes before or after the scheduled time.
2. T F It is ok to take the pills needed for a field trip, place them in a baggie, and label the baggie with the name of the medication and time it is to be given.
3. T F I can keep the medication in the first aid bag and
keep the bag in a handy location during the field trip.
4. T F When I return from the field trip, I must count the medication with a witness, sign it back in, and document that the medication was given.
Answer 1
Correct
Medication must be given within 30 minutes before or after the scheduled time.
Answer 2
False
Only a pharmacist may legally move medication from a labeled container to an unlabeled container and then re-label it. This is called “dispensing.” We don’t “dispense,” we administer medication (from a container labeled by a pharmacist.)
Answer 3
False
The first aid bag is likely to be unsecured and unattended. Medication must be stored in a secure location for student safety and your protection from liability.
Answer 4
Correct
After returning from a field trip, medication must be counted in the presence of a witness, signed back in, and documented that it was given.
Final Steps
Congratulations, you have completed the annual medication refresher course!
Print the form on the next screen to document your completion of this presentation. Turn in the signed form to the District Office.