Administration of Medications at School - October 2010 Revision

This procedural directive was reviewed and revised in June 2012. We provide this revision for historic purposes only.

For purposes of this procedural directive, a “medication” means any substance that is ingested, injected, inhaled or used topically in the diagnosis, treatment and/or the prevention of disease. This includes prescription drugs, over-the-counter and non-prescription drugs.  Health care providers who are licensed by the state of New Mexico to prescribe drugs will authorize medications.  Medication authorizations are acceptable, for example, from licensed medical doctors (MDs), nurse practitioners (NPs), osteopathic physicians (DOs), doctors of oriental medicine (DOMs), physician assistants (PAs) and certified diabetes educators affiliated with medical doctor, as well as clinical nurse specialists or psychologists who have completed the pharmacology course requirements to obtain prescriptive privileges.  Some prescriptive privileges are limited to a specific area of practice for example; a doctor of oriental medicine is only authorized to write prescriptive orders for oriental medicine herbs.

For purposes of this procedural directive, “controlled substance” means a drug or chemical substance whose possession and use are controlled by law.

The following process shall be followed when it is absolutely necessary for a student to take medication during the instructional day.

Process for Administration of Medications at Schools

1. The physician/provider and the parent/legal guardian shall submit written authorization for the medication to be given during the instructional day.  The licensed school nurse shall make every effort to assist the parent/legal guardian in obtaining written authorization for a student’s needed medication.  The information provided in the written authorization ought to match the label information on the medication container.  This ought to help ensure that the medication being taken is consistent with the medication authorized.
2. The parent/legal guardian and physician/provider may submit written consent for a student to self-administer his/her own medication with supervision or without supervision.  A licensed school nurse or duly licensed designee shall administer medication to those students who are unable to administer their own medication.
3. An Albuquerque Public Schools employee shall NOT assist with medication administration without a completed authorization form that has been transcribed by a licensed school nurse.  If a request to administer medication is sent to school without the appropriate written authorization the following steps shall be taken:
1. The licensed school nurse shall be notified immediately of the situation.
2. If the assigned licensed school nurse is unavailable, a buddy nurse(s) or the Nursing Services Office shall be called.
3. Only a licensed school nurse or licensed school practical nurse may telephone a provider to obtain a temporary verbal order for medication.  Such verbal authorizations are valid for five (5) days only and the school nurse shall request that the provider send a written authorization to the school within five (5) working days.
4. The parent/legal guardian may come to school and administer the medication to their child until a verbal or written authorization can be secured by the licensed school nurse.
5. In order to avoid medication errors and assure optimum safety for students,  Albuquerque Public Schools recommends that daily morning medications be given by the parents/legal guardians at home before the school day. If the parent is unable to give the daily morning dose of medication on a consistent basis, the school nurse may assume the daily administration of the morning medication or assist with the self-administration of the daily morning medication at the parent/legal guardian’s request at school.  Albuquerque Public School school nurses, as per the direction of the New Mexico Department of Health School Health Officer, shall not administer occasional or intermittent morning medications in order to avoid double dosing medication errors.
4. In life-threatening emergency situations such as anaphylaxis, severe asthma reaction or a diabetic reaction resulting in loss of consciousness, a non-medically licensed school employee may administer certain oral, inhaled, rectal or parenteral (injectable) medication to a student provided that:
1. A physician/provider written authorization for emergency medication must be on file with the health office at the school for the current school year, unless otherwise allowed by State law, rule or statute.
2. The non-medically licensed school employee is trained by a licensed school registered nurse or a licensed medical provider for the current school year.
5. Non-medically licensed school employees shall be trained to follow a specific procedure for assisted self-administration of medication that assures students receive their medication in a safe and timely manner.  This training shall be provided annually by the licensed school registered nurse.
6. Students shall be carefully instructed in how to take their medication at school.  The method and plan of administration shall be a coordinated effort between the student, parent/legal guardian, the medical provider, licensed school nurse and other school employees who may assist and supervise the student self-administration of medication.
7. Each student shall have each medication in a pharmacy labeled container or an original labeled container if an over-the-counter, non-prescription or doctor of oriental medicine prepared remedy.
   *NOTE: the pharmacy/original label shall NOT serve as a provider’s authorization.  The information on the provider’s written authorization or parent’s written authorization for an over-the-counter medication must match the label on the container.
8. Albuquerque Public Schools recommends that parents/legal guardians transport the medication to school. It shall be the responsibility of the parents/legal guardians to deliver the medication to the health office.  Please refer to the school handbook for specific requirements each school may have.
9. Medication shall be stored in a locked medication cabinet in the health office. Exceptions shall be noted on the medication authorization form or the Individualized Healthcare Plan and shall pertain to medication that must be stored in a refrigerator or those carried by students.
10. The Nursing Services Office shall determine the requirements for recording the date, time and medication administered as well as for monitoring beneficial and/or adverse effects of medication.  These requirements shall be followed at each school as defined in the Albuquerque Public Schools Nursing Manual.
11. One day’s worth of medication (except for controlled substances) may be carried and self-administered by the student without supervision under certain circumstances, provided that:
1. An appropriate written authorization is on file in the health office for the current school year.  An “Authorization to Administer Medication” form signed by the physician/provider and the parent/legal guardian shall be required for prescription drugs that may be given more than short-term (1 to 14 days).  An over-the-counter or short-term prescription authorization form shall be signed by the parent/legal guardian for all over-the-counter, non-prescription, or short-term (1 to 14 days) prescription medications/remedies, unless otherwise allowed by state law, rule or statute.
2. The written authorization shall specify the medication name, dosage and time of administration.
3. The student shall deemed competent to take the medication as ordered on the authorization form.
12. When a student is not competent to carry and administer his/her own medication without supervision or when the medication is a controlled substance  the administration of the medication shall be supervised by a trained Albuquerque Public Schools employee.
13. When the student is not able to self-administer medication, a licensed school nurse shall administer the medication.
14. An Albuquerque Public Schools employee shall NOT send ANY excess medication home with a student .  A parent/legal guardian shall be notified to pick up the excess medication.  Any medication left at the end of the day on the last day of the school year shall be destroyed according to the process in the Albuquerque Public Schools Nursing Manual.
15. An Individualized Healthcare Plan shall be written, by the licensed school registered nurse if medication is to be given on a daily basis for longer than fourteen (14) school days.  A copy shall be filed with the confidential student cumulative health record, in the medication log book and may be given to the parent/legal guardian and appropriate school staff as necessary.
16. The principal shall be responsible for provision of the equipment and materials necessary for the safe storage, administration and documentation of medication taken at school.
17. All requirements and guidelines shall be followed as stated in the Albuquerque Public Schools Nursing Services Medication Procedures.

Administrative Position: Assistant Superintendent for School and Community Support

Department Director: Director of Health and Wellness/Manager of Nursing Services

References

Legal Cross Ref.:   

Board Policy Cross Ref.:

• JL - Student and Staff Wellness

Procedural Directive Cross Ref.:

• Albuquerque Public Schools Nursing Manual (contact Health and Wellness)

Forms:

• Authorization to Administer Medication (contact Health and Wellness)
• Student Accident report (contact Health and Wellness)

NSBA/NEPN Classification: JLCD

Revised: May 1995
Revised: April 1996
Revised: May 1997
Revised: January 2007
Reviewed: September 24, 2010
Revised: October 15, 2010

This page was last updated on: December 9, 2009.