5.3.27

Administering Medication

Policy

To establish guidelines for trained staff to safely store, handle, and administer medications to children while attending center based programs.

All requests for medication administration must be reviewed by the Health Services Manager/Registered Nurse/School Nurse prior to being accepted. Requests for narcotics, insulin, or Glucagon are not allowable.

Children requiring medication at center, will be excluded from attending until all required paperwork has been completed and all required staff have been trained, if needed.

Procedure

Once it has been determined that a child requires any short term or long-term prescription or non-prescription (OTC or Over-the-Counter) medication while at the Center, staff will ensure the following steps have been completed prior to giving the first dose:

1. Parents and physician must complete the School Medication Authorization form. A copy of this form must be kept in the child’s file and a copy must be sent to the Health Services Manager/Registered Nurse/School Nurse. A child who needs an inhaler/nebulizer for asthma management must also have the Consent/Verification form for Inhaler/Nebulizer Care form and the Asthma Questionnaire  completed and signed by the parent.
2. Parents must bring in a duplicate original child-resistant container, which has been labeled by a pharmacist. The pharmacy label must contain the child’s first and last name, the date the prescription was filled, the name of the dose, the medications expiration date, the name and strength of the medication and the instructions for use. The administration instructions on the container, the School Medication Authorization form and the Individualized Health/Medication Plan must match.
3. All medications must be stored in the red medication bag along with the Individualized Health/Medication Plan, School Medication Authorization Form, training log and medication information (if applicable). This may often be stored in a plastic zip-lock type bag. EpiPens, Ventolin inhalers, and any form of albuterol are to be kept at room temperature. See medication information sheet for specific storage information or contact Registered Nurse for specific storage information. Emergency medications (asthma inhalers and EpiPens) do not need to be locked, but must be in the red medication bag and inaccessible to children. Emergency medications must accompany the child outside and on field trips. Keep out of direct sunlight. All other medications must be kept in a locked red medication bag and inaccessible to children. All staff medications at centers must also be inaccessible to children.
4. Parent/guardian must bring the medication and completed School Medication Authorization form to the Center. Medication may not be transported on the bus other than emergency use medications. Staff receiving medication from the parent must check the expiration date on the medication before accepting it from the parent. Please check the inhaler canister or the EpiPen for the expiration date, not the prescription label or box.NOTE: For EpiPens: Make sure the EpiPen (not the trainer pen) is in the box with the prescription label. Send the trainer pen home with the parent. If in doubt call the Registered Nurse to clarify.
5. The Site Supervisor/Head Teacher designates a staff person and a back-up staff person to administer the medication daily. This person should have contact with the parent to relate changes in behavior and with the Health Services Manager/Registered Nurse/School Nurse for questions and training. The Health Services Manager/Registered Nurse/School Nurse will provide verbal instructions and a written plan complete with drug information and side effects to the staff members administering the medication.
6. To allow for safe medication administration:
   • For Head Start and preschool programs, parents must alert teachers to medication given at home by completing the pink Parent Sign-In Sheet for Children Receiving Medication at School form which is kept with the child’s sign-in sheet. All doses of medication given will be tracked on the Medication Administration Documentation This form, and a copy of the School Medication Authorization form, is to be kept with the child’s medication in the medication box. Prior to giving a dose of medication, the teacher MUST check the School Medication Authorization form for the physician instructions and the Medication Administration Documentation form to ensure that the correct amount of time has passed since any previous doses.
   • For Early Head Start programs, all doses of medication will be tracked on the Infant and Toddler Daily Care Log. Prior to giving a dose of medication, the primary caregiver MUST check the “School Medication Authorization” form for the physician instructions and the “Infant and Toddler Daily Care Log” to ensure the correct amount of time has passed since any previous doses.
7. Follow the “5 rights” of medication administration:
   • Right Child – Properly Identify the Child
   • Right Time – Administer the medication at the prescribed time
   • Right Medication – Administer the correct medication
   • Right Dose – Administer the right amount of medication
   • Right Route – Use the prescribed method of administration

   Always wash hands prior to giving any medication to a child.

8. In order to inform parents that a dose of medication was given that day, complete the ½ sheet duplicate form Medication Report to Parents. Keep the original (white) in the child’s file and send the duplicate (pink) copy home to the parents daily. Record any possible concerns or side effects on the form.
9. If a child misses a dose of medication for any reason, staff must call the parents immediately. Any medication errors (wrong dose, wrong child, wrong route, wrong medication, wrong time) must be documented. Contact your Area Manager, Child Development Services Manager and Health Services Manager/Registered Nurse immediately to discuss any further action needed.
10. Medication must be returned to the parent when a child leaves the program or at the end of the program year.

References

• School Medication Authorization – Formster | Form
• Consent/Verification form for Inhaler/Nebulizer Care – Formster | Form 
• Asthma Questionnaire Form
• These documents are provided by the Health Department as needed (no electronic version available, the Health Department will provide as needed):
  • Medication Administration Documentation – log sheet used to track time of administering medication
  • Parent Sign-in sheet for Children Receiving Medication at School
  • Medication Report to Parents – tear-off slip given to parent at pick-up used to inform parents of medication given that day