Medication Administration School Nurse's Guide: A Training ...

MEDICATION ADMINISTRATION SCHOOL NURSE'S GUIDE A TRAINING MANUAL FOR

UNLICENSED PUBLIC SCHOOL EMPLOYEES

VIRGINIA DEPARTMENT OF EDUCATION 2020

Acknowledgements

Editors: Nancy M. Markley, BSN, RN, NCSN-E National Certified School Nurse Emeritus School Nurse Consultant Boston, Virginia 22713

Tracy White, MA, BSN, RN School Health Specialist Virginia Department of Education Office of Special Education and Student Services Richmond, Virginia 23219

A sincere note of appreciation is extended to the following nursing professionals for their assistance in reviewing this edition of the manual.

Diane Allen, MSN, RN, NCSN, CBIS Nurse Manager, School Health Fairfax Health Department Fairfax, Virginia 22903

Tia Campbell, MSN, RN, NCSN-E, FNASN (Retired) Coordinator, Office of Student Health Services Chesterfield County Public Schools Midlothian, Virginia 23112

Rebecca Cooper, BSN, RN School Nurse Coordinator/School Nurse Shenandoah County Public Schools Woodstock, Virginia 22664

Karen Criswell, BSN, RN, NCSN Clinical Coordinator Henrico County Public Schools Henrico, Virginia 23223

Glory Gill, MPA, BSN, RN Health Services Coordinator Hampton City Schools Hampton, Virginia 23669

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Robin L. Hills, DNP, RN, WHNP-BC Deputy Executive Director Virginia Board of Nursing Henrico, Virginia 23233

Patricia Knox, MN, BSN, RN, NCSN Health Services Supervisor Bedford County Public Schools Bedford, Virginia 24523

Suzanne Renegar, MSN, RN Supervisor of Nursing Manassas City Public Schools Manassas, Virginia 20110

Vickie Southall, MSN, RN, NCSN Assistant Professor of Nursing University of Virginia, School of Nursing Charlottesville, Virginia 22030

Linda Torrance, MSN, BSN, RN School Nurse Rappahannock County Public Schools Washington, Virginia 22747

Jeannine Uzel, MSN, RN Director of Public Health Nursing Virginia Department of Health Richmond, Virginia 23219

Charlene Vail, MBA, BSN, RN Coordinator of Health Services Roanoke County Public Schools Roanoke, Virginia 24019

Robin Zophy, MSN, RN, NCSN (Retired) School Nurse Coordinator Gloucester County Public Schools Gloucester, Virginia 23061

Special thanks to Loudoun County Public Schools, Student Health Services, for sharing resources on administering medication for an adrenal crisis.

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Note to School Nurse Trainers

Reference specific policies from your local school board for the school division. Use your school division medication forms, both the online and paper versions, (medication administration record, medication counting, and medication errors) when discussing documentation procedures. It is the School Nurse Trainer's responsibility to assess competency before issuing a certificate of completion of medication administration training to unlicensed assistive personnel (UAP). Consider creating a quiz to assess participants' competency following training. A hands-on demonstration may be appropriate for UAP that administer medications regularly.

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Table of Contents

INTRODUCTION ........................................................................................................................ 6 OBJECTIVES ............................................................................................................................. 7 LEGAL AUTHORIZATION...................................................................................................... 8

State Law ................................................................................................................................ 8 Federal Law ............................................................................................................................ 8 DESIGNATED RESPONSIBILITIES ....................................................................................... 9 Parents..................................................................................................................................... 9 Schools .................................................................................................................................. 10 UAP....................................................................................................................................... 12 QUALIFIED TRAINERS......................................................................................................... 13 Training................................................................................................................................. 13 ACCEPTING MEDICATIONS IN THE SCHOOL SETTING ............................................... 13 Over-the-counter (OTC) Medications................................................................................... 13 Controlled or Prescription Medications ................................................................................ 14 Off-Label Use of Medications .............................................................................................. 15 STANDARD PRECAUTIONS ................................................................................................ 16 Planning ................................................................................................................................ 16 Hand Hygiene ....................................................................................................................... 16 Gloves ................................................................................................................................... 17 Accidental Exposure ............................................................................................................. 17 Reduce Opportunities for Errors ........................................................................................... 17 ADMINISTRATION OF MEDICATION ............................................................................... 17 Right Student ........................................................................................................................ 17 Right Medication .................................................................................................................. 18 Right Dose ............................................................................................................................ 18 Right Time ............................................................................................................................ 18 Right Route ........................................................................................................................... 18 Right Documentation ............................................................................................................ 18 HANDLING MEDICATIONS IN THE SCHOOL SETTING ................................................ 18 COMMON ROUTES OF MEDICATION ADMINISTRATION ........................................... 19 Oral Medications................................................................................................................... 19 Buccal ................................................................................................................................... 20

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