MANSFIELD PUBLIC SCHOOLS

HEALTH SERVICES


POLICY REGARDING ADMINISTRATION OF MEDICATION IN SCHOOLS

September 2006

Regulatory Authority 105 CMR 210.000: M.G.L. c. 94C.s. 7(g); c. 71. s. 54B.
This policy applies to all medications, prescription or non-prescription, which are to be administered to students in school.

1. If a student's physician determines that it is necessary for the student to receive medication during school hours, the written physician's order and specific instructions must be provided to the school. {210.005 (D) (1)}

2. Each medication must be accompanied by a Medication Administration Plan signed by the parent or legal guardian. {210.005 (D) (3)}

3. Medications must be provided by the parent in the original container with the prescription label or manufacturer's label intact. {210.008 (A) (1)} Upon request, pharmacists will provide identical containers and divide medications for school and home. If medication is to be given on field trips, a second identical empty prescription container must be provided by the parent (to send with the person designated to give the medication on the field trip).

4. Each medication which is to be administered for more than 10 school days must be accompanied by a written physician's order. (Prescription label serves as a physician's order for short term medications, such as antibiotics). {210.005 (D) (2) (a)}.

5. All medications administered by school personnel will be documented on the student's medication record.

6. Medications should be delivered to school by an adult. Upon delivery, medications will be dated and counted by the school nurse. {210.008 (A) (273)}

7. The first dose of a newly prescribed medication must be given at home.

8. Medications will be stored in locked cabinets in the Health Offices. {210.008 (C)}

  • Exception: Medications which must be available for emergency access, such as inhalers or EpiPens may be stored in supervised unlocked storage areas, or carried by students as specified in the Medication Administration Plan.
9. Medications will be administered by Registered Nurses {210.002 (2)} employed by Mansfield Public Schools with the following exceptions:
a. Self Administration according to school policy {210.006 (B)}
  • All medications to be self administered must be approved by the school nurse
  • Self administration will be limited to inhalers and very unusual circumstances deemed appropriate by the parent, physician and school nurse


b. Delegation to school staff (The unlicensed staff member will have the option of accepting responsibility for the medication and if willing to administer, will receive training in administration of medication ) for:
  • Field trips
  • Short term special school events
  • A case where a student presents with a life threatening allergic condition, when a school nurse is not immediately available


10. Delegation to school staff (those staff who are not nurses licensed to administer medication in Massachusetts), will be conducted according to the following protocols:
a. The Medication Administration Plan for each medication (including pre-measured injectable medications such as EpiPens) will include a plan for delegation.
b. The Medication Administration Plan will be established when medication is delivered to the school {210.005 (E) (O)} and will remain in place for the school year, unless the school nurse is notified by the parent of needed change.
c. If the Medication Administration Plan includes delegation to unlicensed school staff:
  • It must include signed consent by a parent or legal guardian for unlicensed staff to administer medication
  • The training of unlicensed staff will be provided by the school nurse according to protocols established by the Massachusetts Department of Public Health.


11. "Three times a day" medications will be given at school only if the physician specifically orders a dose during school hours.

12. Administration of early morning or first daily dose of medication is discouraged at school and administered only after careful consideration on an individual basis, according to the following criteria:
a. The nurse who will be responsible for administration of the medication must be informed prior to, and included in any discussion of feasibility of administering the medication. {210.003 (A) 10)}
b. Assessment (related to reason medication is not administered at home) will be conducted by the school nurse and may include a home visit at the discretion of the nurse. c. An Individualized Health Care Plan (signed by the parent) may be added to the Administration of Medication Plan if deemed appropriate by the school nurse.
d. The school nurse may consult with the prescribing physician and address any appropriate questions or concerns regarding morning medication administration {210.005 (H)}, including specific orders, side effects, continuity, blood levels and time parameters. The parent may be asked to sign a release of information to facilitate this communication.

13. If any emergency should occur involving response to medication, the prescribing physician will be notified, and medical treatment will be provided according to the physician's advice and the nurse's assessment.

14. If any error should occur involving administration of medication, the parent will be notified as soon as the error is discovered and a report will be filed with the Superintendent of Schools. The prescribing physician may be consulted by the parent or school nurse if deemed appropriate.

15. This policy will be made available to any parent upon request. Any question between the school nurse and the parent may be reviewed by the principal or other school authority upon request.



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