Medication at School

Legal Authority:

California Education Code (CEC) 49423 
“. . . any pupil who is required to take, during the regular school day, medication prescribed for him by a physician, may be assisted by the school nurse or other designated school personnel if the school district receives: (1) a written statement from such physician detailing the method, amount, and time schedules by which such medication is to be taken and (2) a written statement from the parent/guardian of the pupil indicating the desire that the school district assist the pupil in the matter set forth in the the physician’s statement.” 

Requirements for Medication Administration at School

1. Completion of the Medication Order for School (HS102) (see form below) or its equivalent for ALL medications (including those purchased for over-the-counter use).  Each medication at school order must include a current signed written order by physician, nurse practitioner, or physician’s assistant which indicated the medication, dose, route and times for the medication to be given.  The medication order must also include a signed parent/guardian request and authorization for the medication to be administered at school. 
2. Medication must be provided by the parent/guardian to the school site in a container labeled by a CALIFORNIA pharmacist.  In the case of an over-the-counter medication, the medication must be provided in its original container.
3. Medication at school requests must be renewed annually and are valid for one year.
4. Medication dosing times should be designed to be given out-of-school hours (at home) whenever possible. 

Procedure for Documentation

1. Every Medication Order for School must be documented in HealthMaster in the Prescription Medication screen.  Every medication will be documented as either scheduled or PRN (as need).
2. Medication Order(s) for school will also be documented in the student’s demographic record in HealthMaster under the Medical tab Comments, PRN medication should be noted in the RED ALERT.
3. The original written copy of the Medication Order for School (HS102) will be filed in the student health folder and kept indefinitely.
4. A Report listing the medications required at school will be kept in the Nurse Binder
5. A record of all medication administration will be kept in HealthMaster using the Prescription Administration screen. Scheduled medicates will have a daily notation using the Scheduled Items log indicating the time a medication was given or the reason the medication was withheld. 

Procedure Medication Administration

1. All medication will be stored in the school health office locked medication cabinet.
2. Unlicensed Assistive Personnel (UAP’s) who may be responsible for giving medication in the absence of the nurse, will be in serviced by the assigned site nurse on medication administration on an annual basis or more frequently as needed.  A medication training power point is available on the FUSD Health Services website.  Only regular office staff who have been trained in medication administration by the nurse may administer medication at school.  Substitute office staff MAY NOT administer any medication at school.
3. Every effort should be made to administer medications on a daily basis as ordered.  Students with medication objectives on a 504 Plan or IEP may require extraordinary measures to ensure that medication is received as ordered.
4. Medication should be given within 30 minutes of the time specified.  If a student reports to the health office more than 30 minutes after the time specified, the medication should be withheld until the parent is notified.  DO NOT withhold insulin.
5. Students may not receive missed doses of medication usually given at home unless a specific order to administer missed medication doses was obtained from the physician.  In such cases parental contact must verify the missed dose at home before administering the medication at school.
6. VERBAL ORDERS for medications are NOT to be accepted.  A health care provider may fax or mail the medication order to school.
7. Students will not be allowed to go into the Health Office and take medication unsupervised
8. Parents or parent designees are allowed to administer medication as school as needed. 

Emergency Medication Carried by a Student

Students may carry emergency medication (such as asthma rescue inhalers, insulin, severe allergic reaction kits, and anticonvulsants) and self-administer such medication under the direction of designated school personal provided:

1. The student is physical, mentally, and behaviorally capable in the written opinion of the parent, physician and credentialed school nurse, to assume responsibility and has been adequately instructed by the physician or parent.
2. The medication is necessary to the student’s health and must be taken during school hours.
3. The student has successfully demonstrated self-administration to the credentialed school nurse.
4. Supervision is provided by the school nurse, when available, or designated school personnel. 

Medication Errors

1. All medication errors are to be reported to the Director of Health Services on the Notification of Occurrence Form HS-107 (see form below).
2. Medication errors include, but are not limited to, incorrect medication, incorrect dosage, and medication administered without written health care provider orders.

Dosage Changes

1. Dosage changes must be treated as a new medication at school.  The order must be in written form from the health care provider and the parental consent on HS-102 must be signed by the parent.
2. Medication schedules and dosages cannot be changed in HealthMaster after the medication has been administered one time.  The medication will have to be discontinued and re-entered with the new dosage and/or schedule.
3. Medications may be discontinued by the parent at any time with a verbal or written (preferred) request. 

Disposal of Unused Medication

1. Medication remaining after medication changes during the school years, or at the end of the school year, should be given to the parent/guardian to take home.
2. Asthma inhalers may be sent home with students at the end of the school year or upon parent request.  Controlled medications must be claimed at school by the parent or guardian.
3. Unused medications that are not claimed by the parent/guardian should be bagged and taken to Adult Transitional Program (ATP) for disposal.  The nurse will remove the student’s personal identification information from the prescription container before disposal. ​

Documents for Medication

Asthma Medications

• Asthma Action Plan Fill-in

All Other Medications at School

• Medication at School Order (rev 8-16)
• Parent Consent to Admin Med at School (Spanish-Hmong)

Training Requirements for Medication Administration

• Medication Administration Training FORMS REQUIRED ANNUALLY and as needed (Sept 2012)
• Medication Administration Training PowerPoint (MUST BE VIEWED AT INITIAL TRAINING)
• Nebulizer at School (PS and CDC) LIC9166 Spanish
• Nebulizer at School (PS and CDC) LIC9166

Other Documents

• American Academy of Pediatrics Policy Guidelines for Meds at School
• Med Administration Procedure (flow sheet)
• Medication Inventory Record
• Medication Management Resources UCSF (Fresno)
• Pill Identifier