The supervision of oral and injectable medications shall be in strict compliance with the rules and regulations of the board. Diagnosis and treatment of illness and prescribing drugs and medicines are not the responsibility of the public schools and are not to be practiced by any school personnel, including school nurses, unless authorized in the following rules. The Nurse Practices Act makes it illegal for school nurses to administer prescription medications and treatment that have not been prescribed by a medical person authorized to prescribe medication. The law also prohibits any acts of diagnosis.
In certain explained circumstances when medication is necessary so that the student can remain in school, the school may cooperate with parents in the supervision of prescription medication that the student will use. The parents must submit a written request to the building administrator requesting the school’s cooperation and releasing the school district and personnel from liability.
Under the following rules, the supervision of prescription medications by school personnel, including school nurses, is authorized:
School personnel shall not be required to be custodians of any prescription medication except in circumstances where it is essential that students take such medication during school hours. The medication shall be examined by the designated school employee to determine that it appears to be in the original container, to be properly labeled and to be properly authorized by the written order of a licensed medical person. Only oral medications and injectible medications as ordered by a licensed medical person should be administered except in emergency situations. The school nurse shall be responsible for the overall administration of medications in schools, and may delegate this to an LPN or unlicensed staff member after receipt of the medications, initial assessment and training of the staff member. Should questions arise about the administration of any medication, the nurse may be contacted in person or by telephone.
When the "Permission for Self Administering of Medication" form and a physicians written prescription are on file in the school health room students in grades K-12 may be allowed to keep, in their possession, some prescription medications. This privilege may be at any time denied a student, at which time the prescription medication would be kept in the school health room at all times and administered by the designated staff member. Medications such as psychotics, narcotics, and various other prescription medications will be kept in the school health room at all times and administered only by the designated staff member.
The five requirements in state law 72-8252 which must be met before any student will be granted permission for self administering of medication are:
Where practical, this policy shall be shared with all local physicians, dentists and other professionals who have a license to prescribe medications. Forms should also be made available to the health care providers in the community.
Any changes in type of drugs, dosage and/or time of administration shall be accompanied by parental permission, a newly labeled pharmacy container and a new written prescription from the physician.
Building administrators may choose to discontinue the administration of medication if the administrator first notifies the parents or medical person with an explanation in advance of the date of discontinuance.
Non-prescription drugs may be administered during school hours if the drugs are in their original container and the parent/guardian sends a note giving permission for school staff to administer the drug. If necessary, school personnel who administer non-prescription medications shall seek advice from the school nurse or the administration when administering non-prescription medications on orders of the student’s parent.
Once the "Permission for Self Administering of Medication" form is completed and on file in the school health room students in grades K-12 may be allowed to keep, in their possession, over-the-counter-medications. This form shall include a nursing assessment of the child's ability and skill level to use the medication properly and safely and to use any device necessary to administer such medications as prescribed. The nursing assessment shall include the following questions to be answered yes or no. The student must successfully answer each question to the satisfaction of the nurse before permission will be granted for self administering of medications.
a. Student is capable of identifying the individual medication
b. Student is able to identify specific symptoms and purpose of the medication
c. Student is knowledgeable of medication dosage and method of medication administration
d. Student is able to state side effect/adverse reactions to this medication
e. Student is knowledgeable of how to access assistance for self in an emergency
f. Student is capable of self administering the medication
g. Student is aware of district policy that students cannot distribute medications to another student.
At any time the privilege to keep over-the-counter medication may be denied a student.
The public school shall not provide students with aspirin or any other medication. Deciding whether any drug is needed is a form of diagnosis, and dispensing medication is a form of treatment. Unauthorized administration of unprescribed medications shall not be practiced by any school personnel including school nurses.
Over-the-counter medications shall not be supplied by school employees or kept in athletic areas, and shall not be administered to students unless written parent permission to administer is also provided.
Guidelines for Prescription and Non-Prescription Drugs
The administration of the authorized medication shall be logged by the building administrator or designee in the school's student health file which shall be maintained and filed by the administrator or designee for future reference. An individual record shall be kept of each medication administered. The record shall include student identification, date prescribed or authorized by a parent, name of medication, time and date(s) administered, signature of person administering and section for comments.
After medication is administered, students shall be observed for possible reactions to the medication. This observation may occur at the site of administration or in the classroom.
In the administration of medication, the school employee shall not be deemed to have assumed any legal responsibility other than acting as a duly authorized employee of the school district.
Medications shall be inventoried every semester by a licensed health professional (registered nurse, licensed practical nurse, physician, or pharmacist). Out-of-date stock shall be returned to parent or destroyed.