Medication Administration in School

Transcription

1 Medication Administration in School Southington Public Schools Southington, Connecticut Click each page to proceed.

2 Objectives Understand the definition of qualified personnel. Understand and adhere to medication policy and procedures. Identify the 5 rights of medication administration. Understand correct administration procedures for oral, inhaled, topical and emergency medications to prepare you to meet with your School Nurse for demonstration and training. 2

3 Qualified Personnel Definition Qualified personnel for schools means (a) a full-time employee who meets the local or regional board of education requirements as a principal, teacher, occupational therapist or physical therapist and has been trained in the administration of medication in accordance with Section a-3 of these regulations; (b) a coach and licensed athletic trainer who has been trained in the administration of medication pursuant to Section a-8 of these regulations; or(c) a paraprofessional who has been trained in the administration of medication pursuant to Section a-9 of these regulations. For school readiness programs and before- and after-school programs, directors or director s designee, lead teachers and school administrators who have been trained in the administration of medication may administer medications pursuant to Section a-10 of these regulations. 3

4 SPS Qualified Personnel This presentation was developed to provide you with information about medication administration before you meet with your School Nurse and to have a reference tool for your convenience. There is a brief post-test at the end. Print the test and answer the questions. Bring the completed answer sheet to your scheduled training session with your School Nurse. A School Nurse or Medical Advisor must train Qualified Personnel to administer medication at school. 4

5 SPS Qualified Personnel can administer medications to students if they: Are designated by the site administrator to do so Are trained and supervised by the School Nurse or Medical Advisor Attend training review annually Are willing to do so The term medication refers to any category of prescription and nonprescription preparations and refers to any type of pill, drops, lotion, ointment, cream, liquid, inhalant, intranasal and injectable substance. 5

6 Before You Begin Check that the Medication Authorization Form is dated within one year and complete, signed by parent and MD or authorized prescriber. Authorized prescriber is a physician, dentist, optometrist, advanced practice registered nurse or physician assistant and, for interscholastic and intramural athletic events only, a podiatrist. Note that prescription medications are in the container labeled by the pharmacy listing the student s name, provider s name, medication, dose, frequency and directions for use. Note that over-the-counter medication is in the original container. Wash your hands. It is important to follow hand washing procedures before and after administering medication to the student. 6

7 Check your 5 Rights Only administer the medication prescribed for that individual student. Follow the student s Individualized Health Care Plan (IHCP), Emergency Care Plan and/or Medication Administration Plan (MAP) as needed. The Medication Administration Plan is a documented plan established by the School Nurse in conjunction with the parent and student regarding the administration of medication in school. Such plan may be a standalone plan, part of an individualized health care plan, an emergency care plan or a medication administration form. 7

8 Medication Administration Procedure Follow a standard routine every time to minimize errors. Remember the 5 Rights : Right Student Right Medication Right Dosage Right Time Right Route Have a plan for giving students their daily medication so they are not missed or late: 30 minutes before or after the time authorized is considered OK It is considered an error if later or earlier unless it is a PRN or as needed medication such as an inhaler or EpiPen If more than 30 minutes late, talk to the parent before giving it All medication doses administered must be documented on the student s medication administration record. 8

9 Oral Medications (tablets, capsules, liquids, glucose gel) 1. Wash your hands! 2. Verify the student s identity. Ask the student to state their name. 3. Review the medication order. 4. Retrieve the appropriate medication container, make sure the label matches the student and the physician s order. 5. Pour the correct dosage into the cap of the bottle or medication cup without touching the medication. Double check the medication, dosage, route, time and student then pour the medication into the student s hand. Provide water as needed. 6. Liquid medication should be held at eye level when measuring dosage. 7. Observe student swallowing their medication. 8. Document the medication administration on the medication log. 9. Return the medication container to its secured storage place. 9

10 Topical Medications Wash hands, wear gloves, and follow the 5 rights of medication administration. Wash area if directed. Apply a thin layer of medication as directed using a tongue blade, cotton swab or gloved finger. Cover area if directed. Remove gloves and wash hands. Document. 10

11 Inhaler use Wash hands, and follow the 5 rights of medication administration. Remove mouthpiece cover Shake inhaler well for 2 to 5 seconds Place inhaler in mouth Take a deep breath and exhale completely Inhale slowly and deeply through mouth while depressing the medication canister fully Hold breath for 10 seconds Wait 1 minute between puffs Use spacers if available, they help to deliver medication to the lungs Call parent/guardian if no improvement after inhaler use and the school nurse is not available. Document. 11

12 Follow the Asthma Action Plan, the student s Health Care Plan (IHCP) and/or Medication Administration Plan (MAP) for orders for inhalers. Indications for rescue inhaler use may include: Difficult, shallow rapid breathing Longer time exhaling than inhaling, whistling or wheezing noise with breathing. Unable to speak more than 1-2 words without taking a breath. Coughing continuously Flaring nostrils Neck/chest muscles pull in (retract) with breathing Cyanotic (turning blue) Student states that his/her chest feels tight or complains of difficulty breathing. 12

13 Example: Asthma IHCP (Individualized Health Care Plan) Assessment Date/Nurse Health Concern Nsg. Diagnosis Student Objective(s) Interventions/Responsible Person Evaluation/ Timeline At risk for ineffective airway clearance related to asthma. will follow MD orders and/or asthma plan per MD 100% of the time. will demonstrate proper administration of prescribed medication and will pre-medicate, as needed, prior to activities that may trigger an asthma episode per MD orders 100% of the time. Discuss asthma awareness/ MD orders and/or Asthma Action Plan addressing the warning signs and what to do if an asthma episode occurs. Nurse Discuss asthma management measures with student. Nurse Asthma Action Plan provided by MD Obtain medication orders for any medications needed in school. Nurse Assist student to administer prescribed medications as needed. Nurse Monitor medication administration and reinforce proper technique as needed Nurse, trained principal or teacher Record asthma episodes. Nurse MDI received Self-administer MDI Self-administer Checklist completed Nebulizer in school will participate in school activities with modifications made when necessary 100% of the time. Inform teachers and other appropriate school staff. Nurse Assist PE teachers to modify PE requirements as needed. Nurse Other: 13

14 Epinephrine Auto-injector (EpiPen ) EpiPen is a brand name. There are several brands and types of epinephrine auto injectors. Your School Nurse will train you how to use them when you schedule to meet. Know which students have an epinephrine auto-injector in school. Anaphylaxis is life-threatening and can occur at any time. Know the symptoms of anaphylaxis which may include: Abnormal breathing Chest discomfort or tightness Anxiety Dizziness or light-headedness Cough Difficulty breathing Diarrhea Difficulty swallowing Hives, itchiness Nausea or vomiting Palpitations Slurred speech Swelling of the face, eyes, or tongue Unconsciousness 14

15 EpiPen Administration 15

16 Diabetes Medication Wash hands, and follow the 5 rights of medication administration. Know your student s plan for Diabetes management in school and on field trips. Symptoms of low blood sugar may include: Hunger Shakiness Dizziness Confusion Difficulty speaking Feeling anxious or weak Symptoms of high blood sugar may include: Increased thirst Blurry vision Dry skin Feeling weak or tired Frequent urination 16

17 Blood glucose levels are checked throughout the day and medication is given based on those results. Diabetes medications can include glucose tablets, glucose liquid, glucose gel (follow instructions for oral medications, page 7) insulin, or Glucagon injection. Glucagon is a hormone produced in the pancreas. Glucagon is used to raise very low blood sugar. Glucagon is given by injection in the muscle. It comes as a powder and liquid that will need to be mixed just before administering the dose. SPS training for mixing and giving the injection are in development. Glucagon is administered only if a student is unconscious from low blood sugar. After the injection, they should be turned onto the side to prevent choking if they vomit. Once the Glucagon has been given, call

18 Possible Side Effects of Medications All medications carry the risk of side effects. Listed below are some of the possible side effects of some of the more common medications administered in our schools. Ask your school nurse about specific medication side effects during your training session. Epinephrine Auto Injector: increased heart rate, stronger or irregular heartbeat, sweating, nausea and vomiting, difficulty breathing, paleness, dizziness, weakness or shakiness, headache, apprehension, nervousness or anxiety. These side effects usually go away quickly, especially with rest Mylan Specialty L.P Benadryl (Diphenhydramine): dry mouth, nose, and throat, drowsiness, dizziness, nausea, vomiting, loss of appetite, increased chest congestion, headache, muscle weakness, excitement (especially in children), nervousness 2013 Medline Plus Albuterol (Inhaler): Common side effects of VENTOLIN HFA include: palpitations, chest pain, fast heart rate, shakiness, nervousness, headache, pain, dizziness, sore throat, runny nose GlaxoSmithKline 18

19 Ibuprofen: diarrhea, nausea, gas or bloating, dizziness, nervousness, ringing in the ears, rash, itching, hives, swelling of the eyes, face, throat, arms, hands, feet, ankles, or lower legs, difficulty breathing or swallowing, hoarseness, pain in upper right part of stomach, fast heartbeat 2013 Medline Plus Acetaminophen (Tylenol ): rash, hives, itching, swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs, hoarseness, difficulty breathing or swallowing 2013 Medline Plus Methylphenidate (Ritalin ): Common side effects include headache, decreased appetite, stomach ache, nervousness, trouble sleeping, nausea. Novartis In the uncommon event that a side effect from a medication is observed, follow the prescriber s instructions on the authorization form, call the school nurse and parent/guardian. In any emergency call

20 Student Medication Self-administration Students may self administer their prescribed medication: When self-administration is authorized by their health care provider When the parent gives written consent When the student is competent to do so After signing a self administration assessment and contract 20

21 Field Trips Field Trips are considered part of the school day and therefore medication or medical procedures that are required during the school day must also be provided on a field trip. While on a field trip, the principal s designee trained to administer medication will accompany and stay with the student. The school nurse will make sure the proper medication and/or necessary supplies are sent on the field trip. Follow the SPS FIELD TRIP MEDICATION AND HEALTH CONCERNS before planning your trip. See your school nurse. 21

22 What Is a Medication Error? Dose is omitted Wrong medication Wrong student Inaccurate dose Wrong time Incorrect route Errors may include, but are not limited to, giving the wrong medicine, wrong dosage, wrong student, wrong time, or wrong route. If a med error occurs: notify school nurse, administrator, parents, physician immediately; Monitor student / follow physician instructions; If you are away on a field trip after hours call Poison Control at ; Complete a Medication Error Report found in the Health Office. 22

23 Abbreviations You May See on Labels PRN as needed PO by mouth AC before meals PC after meals BID twice a day TID three times a day QID four times a day QOD every other day Q every QD - everyday Q2H every 2 hours C with S without A - before P after N/V nausea and vomiting NPO nothing by mouth GTTS drops MG milligram ML milliliter OZ ounce TBSP tablespoon (15ml) TSP teaspoon (5ml) 23

24 Review Know and follow the 5 rights of medication administration. Document medication administration appropriately after giving the medication. If you have any questions about the medication follow up with the school nurse. If the student questions the medication, STOP, do not give the medication and recheck the procedure as described in #9. Medication must be kept in a safe location at all times. It is generally accepted that scheduled medication should be administered within 30 minutes before or after the scheduled dose is due. Report any medication error immediately. 24

25 Conclusion Please click the link below to print and complete this post test and bring to your School Nurse for the medication administration review of individual students needs and demonstration of administration. See you next year! Medication Administration Post Test