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Administration of Medicine to Minor Students, Policy No. 590

Printable PDF Board Policy 590

Purpose

The purpose of this policy is to identify when technology center personnel are authorized to administer medication to minor students, when minor students are authorized to self-medicate and how technology center personnel will maintain, administer, monitor and dispose of minor student medication.

Definitions

 For purposes of this policy, these terms have the following definitions:

“Inhaler” means a device that delivers a bronchodilator to alleviate symptoms of respiratory distress that is manufactured in the form of a metered-dose inhaler or dry-powder inhaler and that may include a spacer or holding chamber that attaches to the inhaler to improve the delivery of the bronchodilator.

"Medicine" or “medications” includes prescrip­tion medications, opiate antagonists and over-the-counter medicines such as but not limited to aspirin, cough syrup, medicated ointments and any other item used to treat an illness, disease or malady.  This term shall not include “Sunscreen” as defined below

“Parent” means a parent, a court appointed guardian or a person having legal custody of a minor student.

“Respiratory distress” means the perceived or actual presence of coughing, wheezing or shortness of breath.

 “Sunscreen” means a compound topically applied to prevent sunburn.

Policy

Under Oklahoma law, a school nurse, an administrator or a designated district employee may administer prescription and nonprescription medications and assist in applying sunscreen to minor students.  Only designated employees who have successfully completed specific training in the administration of nonprescription and prescription medications may administer medication to minor students with legitimate health needs

Except as provided in this policy and in the technology center’s diabetes care and management policy, minor students may not retain possession of or self-administer any medicine.  Violation of this rule will be reported to the minor student's parent and may result in discipline, including out-of-school suspension.

As further set out below, the technology center retains the discretion to reject requests for the administration of medication or application of sunscreen and to discontinue the administration of medication or application of sunscreen.

The parent must deliver the minor student’s medicine to the technology center administrator in its original container with the parent’s written authorization for administration of the medicine.  Sunscreen for application by a school nurse must be delivered to the school nurse or technology center administrator in its original container with the parent’s written authorization for application of sunscreen.  The parent's authorization for either medicine or sunscreen must identify the minor student, the medicine or sunscreen, and include or refer to the label for instructions on administration of the medicine.  The administrator or a designated employee will administer the medicine to the minor student or assist the minor student in applying sunscreen pursuant to the parent's instructions and the directions for use on the label or in the physician's prescription.  The parent must complete a new authorization form annually and for each change of medication or sunscreen.  The technology center will maintain the authorization form as a part of the minor student’s health record.  Authorization forms will be available in the campus director’s office.  A parent who chooses to do so may come to the technology center and personally dispense medication or apply sunscreen to the minor student. 

The administration of each campus will keep a record of the minor students to whom medicine is administered or sunscreen is applied, the date of administration or application, the person who administered the medicine or applied the sunscreen and the name or type of medicine or sunscreen administered.

Medications and sunscreen will be stored in a separate locked drawer or cabinet that is readily accessible only to the persons who will administer the medication or sunscreen.  Medications requiring refrigeration will be refrigerated in a secure area. 

Any person administering medicine or applying sunscreen to a minor student will participate in training by October 1 of each year conducted by a school nurse or other health care professional.  The training will include:

•             Review of state statutes and technology center rules and regulations (including this policy) regarding administration of medication by technology center personnel;

•             Procedures for administration, documentation, handling and storage of medication and sunscreen; and

•             Medication needs of specific minor students, desired effects, potential side effects, adverse reactions and other observations.

Only those persons who successfully complete the training are authorized to administer medication or apply sunscreen.  Each campus site will maintain a current list of those authorized to administer medication and apply sunscreen at that site.

Minor students who are able to self-administer specific medications, such as inhaled asthma medication, anaphylaxis medication, replacement pancreatic enzymes, or use specialized equipment, such as an inhaler or Epinephrine injector, may do so provided such medication and specialized equipment are transported and maintained under the minor students’ control in compliance with the following rules:

·         A licensed physician or dentist must provide a written order that the minor student has a particular medical condition (asthma, anaphylaxis, cystic fibrosis, etc.), is capable of and has been instructed in the proper method of self-administration of medication.  It is the parent’s responsibility to contact the physician and have the physician complete and return the required order.

·         The parent must provide a written authorization for self-administration of medication.

·         Parents who elect self-administration understand and agree that the technology center, its agents and employees shall incur no liability for any adverse reaction or injury the minor student suffers as a result of self-administration of medication and/or use of specialized equipment.

·         The written authorization will terminate at the end of the technology center year and must be renewed annually.

·         If the parent and physician authorize self-medication, the technology center is not responsible for safeguarding the minor students’ medications or specialized equipment.

·         Minor students who self-medicate are prohibited from sharing or playing with their medication or special equipment.  If a minor student engages in these activities the parent will be contacted and a conference will be scheduled with the parent, minor student, nurse and other appropriate persons.

·         Minor students will not be allowed to self-administer:

·         Narcotics;

·         Prescription pain killers;

·         Medication used to treat ADD/ADHD or other psychological or behavior disorders; and

·         Other medication hereafter designated in writing by the technology center.

·         Except as otherwise provided by an individual minor student’s technology center health plan, minor students may self-administer non-diabetes and non-anaphylaxis-related injectables only in the campus director’s office in the presence of authorized technology center personnel. Diabetes-related injectables will be administered in accordance with the technology center’s diabetes care and management policy.

·         Minor students who self-medicate are encouraged to wear Medic Alert bracelets or necklaces.

·         The parent will provide an emergency supply of a minor student's inhaled asthma medication or anaphylaxis medication or replacement pancreatic enzymes to be administered by technology center personnel, as required by state law.

Minor students who are able to self-apply sunscreen may do so provided such sunscreen is regulated by the Food and Drug Administration. Minor students may self-apply sunscreen

without the written authorization of a parent, legal guardian or physician. All students are permitted to possess sunscreen that is regulated by the Food and Drug Administration.

Sunscreen

Technology center staff will only assist the minor student in applying sunscreen with the parent’s written authorization and according to label directions or, if applicable, written instructions from the minor student’s physician. The sunscreen must be in the original container indicating:

•             Ingredients; and

•             Directions for Application.

Nonprescription Medication

Technology center staff will only administer nonprescription medication with the parent’s written authorization and according to label directions or written instructions from the minor student’s physician.  The medication must be in the original container that indicates:

•             Minor student name (affixed to the container);

•             Ingredients;

•             Expiration date; 

•             Dosage and frequency;

•             Administration route, i.e., oral drops, etc.; and 

•             Other directions as appropriate

Technology center staff will only administer aspirin (acetylsalicylic acid) and products containing salicylic acid with written instructions from the minor student’s physician.  The parent must provide and maintain a supply of nonprescription medication for the minor student.

Prescription Medication

Technology center staff will only administer prescription medication with written authorization and instructions.  Prescription medication must be in the original container that indicates:

•             Minor student name;

•             Name and strength of medication and expiration date;

•             Dosage and directions for administration;

•             Name of the licensed physician or dentist;

•             Date, name, address and phone number of the pharmacy.

The parent must provide and maintain the supply of prescription medication for the minor student.

The parent must reclaim any remaining medication by the last official day of the technology center closing or within seven days after the prescribing physician discontinues the medication.  The designated employee will destroy in a nonrecoverable fashion in the presence of a witness any medication not timely reclaimed.  The person who destroys the medication will record the following information:

•             Date of destruction;

•             Time of destruction;

•             Name and quantity of medication destroyed; and

•             Manner of destruction of medication

Any and all controlled substances will be destroyed according to state law.

The designated employee will advise the principal if discontinuance of medication to a minor student is appropriate and assist in informing the parent.  Legitimate reasons for discontinuing administration of medication include, but are not limited to the following:

•             A legitimate lack of space or facility to adequately store specific medication;

•             Lack of cooperation by the minor student, parent and/or prescribing doctor;

•             An unexpected and/or adverse medical reaction to the medication at technology center, i.e., mood change, allergic reaction, etc., considered to be harmful to the health and well-being of the minor student;

•             Any apparent change in the medication’s appearance, odor, or other characteristics that raise reasonable doubts about the quality of the medication; and

•             The medication expiration date has passed.

Seizure-Rescue Medication (Seizure-Safe Schools Act)

Beginning January 1, 2022, at every technology center site that has a student enrolled who (1) has a seizure disorder and (2) has a seizure rescue medication or other medication prescribed to treat seizure disorder symptoms approved by the Food and Drug Administration and any successor agency that is prescribed by the student’s health care provider, the technology center shall have at least one employee who has met the training requirements necessary to (1) administer or assist with the self-administration of seizure medication, and (2) recognize the signs and symptoms of seizures and the appropriate steps to be taken to respond to these symptoms. For purposes of this training, the technology center is permitted by law to use any adequate and appropriate training programs or guidelines for training of technology center personnel in the seizure disorder care tasks covered under this policy.

Before a seizure rescue medication can be administered to a student to treat seizure disorder symptoms, the student’s parent or legal guardian shall do the following:

A  provide the technology center with written authorization to administer the medication at the technology center, 

B. provide a written statement from the student’s health care provider that shall contain the following information:

§  the student’s name,

§  the name and purpose of the medication,

§  the prescribed dosage,

§  the route of administration,

§  the frequency that the medication may be administered, and

§  the circumstances under which the medication may be administered;

C.      provide the prescribed medication to the technology center in its unopened, sealed package with the label affixed by the dispensing pharmacy; and

D.     collaborate with technology center personnel to create a “seizure action plan,” which means a written, individualized health plan designed to acknowledge and prepare for the health care needs of a student diagnosed with a seizure disorder.

The written authorization and seizure action plan shall be kept on file in the office of the technology center nurse or technology center administrator, and it shall be distributed to any technology center personnel or volunteers responsible for the supervision or care of the student. The written authorization and seizure action plan shall be effective only for the school year in which written authorization is granted and may be renewed each following school year upon fulfilling requirements A–D above. The technology center shall follow all administrative rules promulgated by the State Board of Education for the development and implementation of the seizure education program and the procedures for the development and content of seizure action plans.

Pursuant to state law, a technology center employee may not be subject to any disciplinary proceedings resulting from an action taken in compliance with Seizure-Safe Schools Act, and

any employee acting in accordance with the provisions of that act shall be immune from civil liability unless the actions of the employee rise to the level of reckless or intentional misconduct. Any technology center-employed nurse shall not be responsible for and shall not be subject to disciplinary action for actions performed by a volunteer.

Administration of Opiate Antagonists (e.g., Narcan) by Technology Center Personnel

Technology center medical personnel (certified school nurse or any other nurse employed by or under contract with the technology center) or any other person designated by the Superintendent may administer an opiate antagonist for a suspected opiate overdose by a student or other individual exhibiting signs of an opiate overdose.

The Superintendent may authorize one or more technology center employees to receive training offered by the Department of Mental Health and Substance Abuse Services, a law enforcement agency or any other entity in recognizing the signs of an opiate overdose and administering an opiate antagonist. The Superintendent may designate persons to receive this training who have been required to receive annual training in cardiopulmonary resuscitation and the Heimlich maneuver (70 Okla. Stat. §1210.199).   Furthermore, if a person or persons designated and trained to administer an opiate antagonist are absent, the Superintendent or designee may authorize any person to administer an opiate antagonist to a student or other individual exhibiting signs of an overdose. 

 Any person administering an opiate antagonist to a student or other individual at a technology center site or technology center-sponsored event, in a manner consistent with addressing opiate overdose, shall be covered by Oklahoma’s Good Samaritan Act.  In the event of a suspected overdose, the technology center and its employees or designees shall be immune from civil liability in relation to the administration of an opiate antagonist.

Reference:

Okla. State. tit 70§ 1-116.2, 70§ 1-116.3

Okla. Stat.  tit. 70 § 1210.199

Okla. Stat.  tit. 70 §1210.242

Okla. Stat.  tit. 63 §1-2506.1

Okla. Stat. tit. 70, § 1210.183