10/20/14& the administration of nasal naloxone by school nurses. for nasal naloxone

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1 Mary Ann Gapinski, MSN, RN, NCSN Director of School Health Services MDPH I do not have a financial relationship or interest in any proprietary entity producing health care goods or services related to the content of this continuing education activity nor does any of my immediate family members.! Explain proposed DPH Guidelines regarding the administration of nasal naloxone by school nurses! Identify sources for obtain standing orders for nasal naloxone! Identify sources for obtaining nasal naloxone 1&

2 A school nurse, may be trained by MDPH approved trainers for the purpose of providing training for unlicensed individuals to administer naloxone by nasal administration or by auto injector in a life-threatening situation when first responders are not immediately available.! MDPH approved policies, curriculum and procedures for training.! School nurses are trained and tested for competency in accordance with standards and a curriculum established by the Department.! Trainers arrange for trainings of school nurses in local communities, in accordance with standards and curriculum established by the Department.! The school nurse will document the training and testing of competency as established by the Department. The training, at a minimum, will include: (a) Procedures for risk reduction; (b) Recognition of the symptoms in an individual with an opiate overdose; (c) The importance of following the prescribed method of medication administration; (d) Proper use of both the nasal inhaler method and by auto-injector; (e) The requirement to call local emergency services prior to administration, and (f) Requirements for proper storage and security, notification of appropriate persons following administration, and record keeping.! All trainings in the administration of naloxone will be done in accordance with prescribed methods.! Priorities for trainings will be in communities where individuals most at risk have been identified.! School nurses will contact local coalitions in their communities of the availability of these trainings. 2&

3 ! The school nurse maintains and makes available upon request a list of all unlicensed individuals trained to administer naloxone by nasal administration or auto injector.! School nurses submit a report to the MDPH School Health Unit each time training of naloxone administration is completed.! All other medication administration procedures will hold forth including: (a) reporting of any medication errors per 105 CMR (b) proper disposal of a used naloxone administration delivery system! Naloxone is not a controlled substance but is a regulated substance (a prescription medication) that requires a licensed prescriber.! Prescriptions for intra-nasal naloxone can be filled at many local pharmacies.! Several pharmacies have standing orders for dispensing naloxone as well. 3&

4 Acts&of&2012,&Chapter&192,&Sec7ons&11&&&32&& Passed August 2012 (d) Naloxone or other opioid antagonist may lawfully be prescribed and dispensed to a person at risk of experiencing an opiate-related overdose or a family member, friend or other person in a position to assist a person at risk of experiencing an opiate-related overdose. (emphasis added) (a) A person who, in good faith, seeks medical assistance for someone experiencing a drugrelated overdose shall not be charged or prosecuted for possession of a controlled substance under sections 34 or 35 if the evidence for the charge of possession of a controlled substance was gained as a result of the seeking of medical assistance. (b) A person who experiences a drug-related overdose and is in need of medical assistance and, in good faith, seeks such medical assistance, or is the subject of such a good faith request for medical assistance, shall not be charged or prosecuted for possession of a controlled substance under said sections 34 or 35 if the evidence for the charge of possession of a controlled substance was gained as a result 4&

5 (a) A person who, in good faith, seeks medical assistance for someone experiencing a drugrelated overdose shall not be charged or prosecuted for possession of a controlled substance under sections 34 or 35 if the evidence for the charge of possession of a controlled substance was gained as a result of the seeking of medical assistance. (b) A person who experiences a drug-related overdose and is in need of medical assistance and, in good faith, seeks such medical assistance, or is the subject of such a good faith request for medical assistance, shall not be charged or prosecuted for possession of a controlled substance under said sections 34 or 35 if the evidence for the charge of possession of a controlled substance was gained as a result (c) The act of seeking medical assistance for someone who is experiencing a drug-related overdose may be used as a mitigating factor in a criminal prosecution under the Controlled Substance Act,1970 P.L , 21 U.S.C. section 801, et seq. (d) Nothing contained in this section shall prevent anyone from being charged with trafficking, distribution or possession of a controlled substance with intent to distribute. (e) A person acting in good faith may receive a naloxone prescription, possess naloxone and administer naloxone to an individual appearing to experience an opiate-related overdose. 5&