Ews.semcac.org:8443



GENERAL PROCEDURES FOR ADMINISTERING

MEDICATIONS

To successfully complete this training you will need to:

• View Module 3 How to Administer Medication

2013 American Academy of Pediatrics

• Read the following information, and sign off on last page

• Teacher and at least one para at the site must be trained in giving medication.

ADMINISTERING MEDICATION BY THE VARIOUS ROUTES

ORAL TABLET/CAPSULES

1. When pouring tablets/capsules use the lid of the container to pour the medication, then drop the medication into a medicine cup. Do not handle medications with your fingers. Use a tweezers if necessary to move or touch medications.

2. For children who have difficulty in swallowing medications, the following techniques may be helpful to gain cooperation, as well as assist the child to take all medications:

a. Have the child in a sitting position for easier swallowing.

b. Offer tablets/capsules one at a time. If necessary, place medication in the child’s mouth toward the back of the tongue.

c. Offer a drink of liquid after each medication. Use a straw if necessary.

d. Allow the child to rest a short time after each medication is taken.

e. Allow enough time for the child to swallow each medication.

f. Tablets or capsules may be easier to swallow if given with food, such as applesauce, if permitted.

g. Some children need their medication crushed. Do not crush enteric coated tablets or open capsules.

h. If the child has continued difficulty taking oral medications, contact the parent. The health care provider may need to be consulted. The medication may be available in another form.

ORAL LIQUIDS

These are medications that are poured, measured, and swallowed.

1. Check to see that the cap of the bottle is on securely.

2. Read instructions to determine if contents are to be shaken as with a suspension. A rotating wrist movement will ensure a more thorough mixture.

3. Remove the cap and place it with the open side up.

4. Hold the bottle with the label toward the palm of the hand to avoid soiling the label.

5. Locate the marking on the medication cup for the amount of medication to be poured.

6. Pour the medication at eye level. Take care to not pour more than what is needed.

7. Clean the lip of the bottle, if necessary, with a moist paper towel before recapping.

APPLICATION OF EYE DROPS/OINTMENTS

1. Instruct the child about the procedure. Child needs to sit or lie down with head tilted back.

2. Cleanse the eye(s) with a clean tissue, clean and wet washcloth or cotton ball. Always cleanse from the inside of the eye, near the nose, to the outside. Use a clean tissue or cotton ball for each wipe.

3. Remove cover of container, place lid with open side up.

4. Instruct client to look upward toward the top of their head.

EYE OINTMENT: Retract lower lid. (Make a pocket) Approach eye from out of field of vision. With due care to avoid contact with the eye, apply the ointment in a thin ribbon, into the lower lid pocket.

EYE DROPS: Retract lower lid. (Make a pocket) It may be necessary to separate the eyelids. Approach eye from out of field of vision. With due care to avoid contact with the eye, apply eye drop gently to the center of the lower lid. Do not allow the drop to fall more than one inch before it contacts the eye.

5. Following application, instruct child to look downward and then close eye(s) for a short time.

6. Wipe the excess ointment/drops with a clean tissue/cotton ball.

EAR DROPS

1. Hold ear lobe in such a manner to allow visualization of the ear canal.

2. Instill ordered number of drops without touching dropper to the child’s external ear.

3. When instilling eardrops into both ears, place a cotton ball in the external portion of the first ear before turning the head to instill drops in the other ear.

4. Instruct child to lay quietly a short time to allow the medication to reach the eardrum.

NOSE DROPS/SPRAYS

1. For nose drops, help the child to lie down with the head extended over a pillow. The client may sit up for nasal sprays.

2. Avoid touching the dropper or spray nozzle to the child’s nose.

NOSE DROPS: Place the nose dropper just inside the nostril, and instill the correct number of drops. Instruct the child to remain with head back for a short time.

NASAL SPRAYS: Instruct the child to sniff on the count of three as you squeeze the nasal spray. This will help to coordinate the child’s sniffing with the application of the medication. Optional: Close one nostril while spray is applied to the other nostril.

INHALERS

These medications are inhaled by the child using a dispenser, commonly called an inhaler.

1. The child should be in a sitting position.

2. Read instruction on the inhaler to determine if the medication is to be shaken.

3. Grasp the medication dispenser and remove the mouthpiece.

4. Hold the dispenser’s mouthpiece approximately 1 inch from the child’s mouth. If a spacer is used, the spacer of the dispenser may be placed into the mouth between the teeth.

5. Instruct the child to exhale, and, on the count of three, to breathe in deeply as you dispense the medication, and then hold their breath for 10 seconds, if possible, before exhaling.

6. Wipe off the mouthpiece or spacer before replacing the mouthpiece cover.

Technique for Proper Use of Metered Dose Inhalers

1. Remove the cap and hold inhaler upright.

2. Shake the inhaler.

3. Tilt the head back slightly and breathe out.

4. Position the inhaler in one of the following ways:

a. Open mouth with inhaler one to two inches away.

b. Use spacer with inhaler; place spacer in mouth (Spacers are particularly beneficial for older adults and young children.)

c. Position inhaler in mouth, close lips around inhaler

5. Press down on inhaler to release medication as you start to breathe in slowly.

6. Breathe in slowly (over 3 to 5 seconds).

7. Hold breath for 10 seconds to allow medication to reach deeply into lungs.

8. Repeat puffs as directed. (Waiting one minute between puffs may permit additional puffs to penetrate the lungs better).

NEBULIZER TREATMENTS

A nebulizer changes medication from a liquid to a mist so that it can be more easily inhaled into the lungs. Nebulizers are particularly effective in delivering asthma medications to infants and small children and to anyone who has difficulty using an asthma inhaler.

It is also convenient when a large dose of an inhaled medication is needed. Nebulized therapy is often called a ‘breathing treatment.’ And a variety of medications – both for immediate relief and maintenance of asthma symptoms – are available for use with a nebulizer.

Parent will provide medication and equipment as needed. Parent will train staff on use of equipment. Parents are encouraged to come to the center to administer the medication/treatment.

Once you have the necessary supplies:

1. Place machine on sturdy surface and plug into outlet.

2. Wash your hands with soap and water and dry completely.

3. Carefully measure medications exactly as you have been instructed and put them into the nebulizer cup. Most medications today come in premeasured unit dose vials so measuring is not necessary. If you do measure, use a separate, clean measuring device for each medication.

4. Have the child sit up straight on a comfortable chair or sit on your lap. If you are using a mask, position it comfortably and securely on the child’s face. If you are using a mouthpiece, place it between the child’s teeth and seal the lips around it.

5. Encourage the child to take slow, deep breaths. If possible, hold each breath for 2-3 seconds before breathing out. This allows the medication to settle into the airways.

6. Continue the treatment until the medication is gone.

7. If dizziness or jitteriness occurs, stop the treatment and rest for a bout 5 minutes. Continue the treatment, and try to breathe more slowly. If dizziness or jitteriness continues to be a problem with future treatments, inform the parent and encourage parent to contact the child’s health care provider.

TOPICAL

If medication is to be applied to the skin (topical) gloves are to be worn.

1. Wash your hands

2. Put on gloves

3. Apply medication to appropriate area following directions given

4. Following application, remove gloves and dispose of properly.

5. Wash your hands

RECTAL SUPPOSITORY PROCEDURE (Emergency Only)

To be administered by EMS or parent

Children who have chronic health conditions such as asthma, allergies, etc that require medications to be given at Head Start for the noted condition, must have a completed Individual Child Care Plan (ICCP), signed by the parent and the child’s health care provider. Other forms of documentation, such as an Asthma Action Plan with medication order noted on the form along with the health care provider signature, is acceptable documentation. This needs to be completed and available to Head Start staff prior to giving medications such as nebulizer treatments, inhalers etc.

Parents will complete the Permission to Administer Medication Form for short term medications to be given at Head Start, such as ear drops or an oral antibiotic for 10 days, etc. .

It is not required that the health care provider sign this form.

The information given on the form must match what the prescription bottle states.

Semcac Head Start

Policies, Responsibilities & Procedures

| PRP Subject: |Medication Administration | PRP #: | |

|Part: |1304 | PC Approval Date: | |

|Subpart: |Early Childhood Development and | Last Reviewed Date: |7.2016 updated |

| |Health Services | | |

|Section Title(s): |Child Health and Safety | Implementation |Teacher, CC, Health Coordinator |

| | |Responsibility: | |

|Related Performance |PS. 1304.22(c)(1)-(6),(d)(1); | Monitoring |Health Coordinator |

|Standard(s) and/or DHS |1308.18(c)(d) |Responsibility: | |

|Licensing Standards |DHS Licensing 9503.0140 | | |

| |Subp. 7(A-E) | | |

|(A) Policy: |Semcac Head Start establishes and maintains written procedures regarding the administration, |

| |handling, documentation and storage of medications that has been prescribed by a healthcare |

| |provider for the enrolled children as well as staff and volunteers. It is our policy to |

| |cooperate with the parent/guardian and his/her physician by administering medication as ordered|

| |during center day hours. A safe, locked place for medication storage will be provided. |

|(B) Responsibility: |Teachers, Para Professionals, Home Based Educators |

|(C) Procedure: |The administration of medication to children shall be done ONLY in circumstances where the |

| |physician feels the child needs medication given during center time. The parent/guardian must |

| |give written permission or complete the appropriate forms (ICCP or Permission to Administer |

| |Medication Form) before any medication can be given. Documentation will be made each time |

| |medication is given on the Medication Log form. Unused medication will be returned to the |

| |parent/guardian by the Teacher and documented on medication log form. No over-the-counter |

| |medication will be given unless staff has received written documentation from a medical |

| |provider. |

| | |

| |All staff administering medication will review and sign off on the Medication Administration |

| |Guide. Every teacher has a copy. |

| | |

| |PROCEDURE: |

| |Parents should be encouraged to give children medication before or after Head Start hours if |

| |possible. Medications that must be given during Head Start hours must be brought into the |

| |center and given to the Teacher. Medication must be stored in a locked area at the center. |

| |Medication cannot be transported in the child’s backpack. |

| |Children will not be given any medications without written permission from the parent and |

| |ordered by a doctor. This also includes hand/body lotions, cough drops, lip balm (gloss), |

| |insect repellents, antibiotic ointments, Tylenol, or any other skin or oral products. The |

| |exception is sunscreens and diapering products. |

| |Medication to be given to enrolled children during center day hours must be in the original |

| |container, with a legible label stating the child’s name, the medication name and dosage, and |

| |name of the doctor who prescribed it and expiration date. |

| |The “Permission to Administer Medication” form or Individual Child Care Form (ICCP), if |

| |appropriate, is to be completed by the parent prior to staff administering any medication. |

| |This form is dispersed as directed at the bottom of the form. When this form is not available |

| |to the parent, written permission from the parent is acceptable. |

| |All medications given will be documented on a Medication Log form. Each child will have their |

| |own form. A copy of the Medication Log will be sent home with a child that has a received |

| |medication during the center day if it is to be given on an as needed basis only. |

| |When medication is given, complete the Medication Log form. For Amount of medication and route|

| |given, use: |

| |(O)-Oral (T)-Topical (N)-Nasal (P)-Parenteral (ex: injection) |

| |(R)-Rectal (ED)-Eye Drops (I)- Inhaled |

| |The Medication Log form will be completed at time medication is given and dispersed as directed|

| |on bottom of form. |

| |Medication is kept in a locked box at all times and refrigerated if directed. Medication is |

| |always out of reach of children. Sites will have a designated locked area where |

| |staff/volunteers store their medication and purses as they must be in a locked area (most lock |

| |them in the filing cabinet). |

| |Administer medications in a private setting, to respect the privacy of the child. |

| |Contact the parent about staff observations, behavior changes, etc. Document observations and |

| |parent contacts in Child Plus. |

| |Review with parents at regularly scheduled contacts medications given, observations, etc. |

| |Document this on the contact forms/ and Child Plus. |

| |Assist the parents in communicating with their physician regarding the affects of the |

| |medication as needed. |

| |Information on some of the more common medications is available to staff in the Medication |

| |Administration Guide. Staff can request information regarding medication, side affects, |

| |dosage etc. at any time from the Health Coordinator. |

| |Staff receives training on administering medication through self study materials which are part|

| |of the Medication Administration Guide, and as needed. |

| |If a medication is given incorrectly, a medication error, parent needs to be notified and an |

| |Accident/Incident Report will be completed. Heath Coordinator will be notified. |

| | |

| |Certain medications require specific monitoring. Guidance will be given accordingly. Refer to|

| |Medication Administration Guide for further direction. |

| | |

| |EPIPEN PROCEDURE: |

| |See Rescue Medications PRP Rescue medications. |

| | |

| |GUIDELINES: |

| |Read the label to ensure proper storage and to see if medication needs shaking before |

| |administration. |

| |Store medications as instructed. |

| |Medications should be measured with standard measuring devices. |

| |Don't call medications "candy" to persuade a child to take it. |

| |Be alert to any side effects that may develop as a result of the medication. |

| |A copy of "ICCP/Permission to Administer Medication” is to be submitted to the Health |

| |Coordinator and a copy is to be kept in the locked medication box. |

| |Health Coordinator will review, note, attach in ChildPlus. |

| | |

| |PLEASE MAKE SURE THAT YOU HAVE THE RIGHT CHILD |

| |AND THE RIGHT MEDICATION |

| | |

| |Guidelines for using Diapering products and Sunscreen |

| | |

| |Sunscreen lotions and Diapering Products will be applied providing we have the following: |

| |Written permission from the parent (use Permission to Administer Medication Form) to use an |

| |over the counter diapering product. We do NOT need direction from a doctor. Each child must |

| |have their own diapering product. |

| |Permission to use Sunscreen lotion is part of the Family Program Agreement |

| |Head Start is to provide the sunscreen lotion/diapering product as appropriate. |

| |These products must be stored up and out of reach out children |

|(D) Forms, Handouts, Flyers: |Permission to Administer Medication, Medication Log, Medication Administration Guide, ICCP |

| |Family Program Agreement |

H. 18: Medication Administration Skills Check List - Self Study

Staff Name: 2017-2018 Comments 2018-2019

|Knows policy on medications. | | | |

| 1.All medications ( prescription and | | | |

|over the counter) need to be prescribed by | | | |

|a health care provider. | | | |

|A parent/legal guardian must provide written permission before | | | |

|medication is given. | | | |

|Head Start forms giving permission: | | | |

|Permission to Administer Medication (PAM) | | | |

|ICCP form before medications are given | | | |

| 2. Medications must be in a prescription | | | |

|Bottle with appropriate label or the | | | |

|original container. | | | |

| 3. Medications are stored in locked | | | |

|medication box and refrigerated if needed. | | | |

| 4. Only designated/trained staff | | | |

|members give medications while at | | | |

|Head Start. | | | |

| 5. A Head Start form Medication Log will | | | |

|be maintained on each child | | | |

|receiving medications at Head Start. | | | |

| 6. Each site has the following: | | | |

|a. Parent authorization forms (ICCP or | | | |

|PAM) | | | |

| b. Medication Administration Log – 1 per | | | |

|child | | | |

| c. Medication administration | | | |

|procedure. | | | |

| d. Trained staff able to | | | |

|administer medication. | | | |

|Knows and follows procedure when forms and medications are | | | |

|received. | | | |

| 1. Familiarize self with the medication | | | |

|that each child is taking. | | | |

| 2. Check possible side effects for each | | | |

|medication. Contact HC for guidance. | | | |

| 3. Check label on bottle to make sure | | | |

|information is clear and medication is not | | | |

|expired. | | | |

| C. Knows how to administer medications. | | | |

|Wash hands. | | | |

| 2. Check Permission to Administer Medication | | | |

|Form or ICCP for: | | | |

|Label a. Child’s name. | | | |

|States: | | | |

| b. Name of medication. | | | |

| c. Dosage unit and amount of medication | | | |

|to give. | | | |

| d. Route by which the medication is to be | | | |

|taken. | | | |

| e. Time medication to be given | | | |

| f. Check to see if medication has already | | | |

|been given. (medication log form) | | | |

| 3.Check label on medication to correspond with | | | |

|Permission to Administer Medication or ICCP form (should match | | | |

|all points listed in #2, a-f)) | | | |

| 4. Handle medication appropriately, | | | |

|whether pills, liquid, drops, ointment. | | | |

|(Do not touch medication with hands.) | | | |

| 5. Give child medication. Check label. | | | |

| 6. Replace medication and place in locked box in| | | |

|cabinet, drawer or refrigerator and wash hands | | | |

| | | | |

|7. Record medication given, on Medication | | | |

|Log Form in appropriate date space and | | | |

|sign. | | | |

| * A new Permission to Administer | | | |

|Medication Form is needed before any | | | |

|changes in medication can be | | | |

|given at Head Start. If changes are | | | |

|requested immediately, contact HC. | | | |

| *Discontinued use of medication can be | | | |

|done any time by the parent, either | | | |

|verbally or in writing. This must be | | | |

|documented in Childplus, by staff. | | | |

| | | | |

|*. Any problems or concerns should be | | | |

|communicated to parent, HC, and | | | |

|documented in Childplus in health notes | | | |

|section. | | | |

| | | | |

|DATES OF REVIEW (HC) | | | |

I have viewed the Module 3 How to Administer Medication Video and reviewed the Medication Administration Guide and Checklist.

I will contact the Health Coordinator if I feel I need further training in this area.

___________________________________________ _______________ (2017-2018)

Staff person Date

___________________________________________ _______________

Staff Person Date

___________________________________________ _______________(2018-2019)

Staff Person Date

___________________________________________ _______________

Staff Person Date

**Review and Date Annually**

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