SDE: Clinical Guidelines Ch7R

Clinical Procedure Guidelines for Connecticut School NursesPrintable version | Back to Contents
7
Specialized Health Care Procedures

R. Oral or Inhaled Medication Administration

Definition

Placing medication in a studentís mouth to be swallowed or inhaled.

Purpose

To maintain a medication regime prescribed by an authorized health care provider.

Equipment

Warning: Not all medication is designed to be crushed due to the coating and the pharmacological action of the medication. Serious side effects can occur from administering crushed medication not recommended by the manufacturer.

Based on the medication and the form that the student requires to swallow.

Oral medication

  • Liquid medications require a precise measuring device such as a syringe or plastic dose-marked medication cup.
  • Pills or tablets may require:
  • Crushing utensil (i.e., mortar and pestle, for those that are appropriate for crushing).
  • A student-specific food substance to mix it with (e.g., applesauce).

Inhaled medication

See Asthma and procedures below for specific inhaled medication technique options.

Procedures

  1. The fundamental legal and safe medication administration procedure requires the Six Rights of Medication Administration, which includes the
    1. right medication;
    2. right dose;
    3. right student;
    4. right route;
    5. right time; and
    6. right approach.
  2. All medications administered in school must adhere to the Regulations of Connecticut State Agencies, Administration of Medications by School Personnel and Administration of Medication During Before- and After-School Programs and School Readiness Programs and the districtís policies and procedures, including the specific requirements for controlled substances.
  3. A medication authorization signed by the prescribing provider and parent/guardian is required for each medication.
  4. Prior to administration, each medication, dose, time, and route must be confirmed with the medication authorization.
  5. The person administering the medication should be the same person pouring the medication from a container with the studentís name and prescription label.
  6. An accurate student identification is required.
  7. The person administering the medication needs to ensure that the medication was swallowed.
  8. Assisting a student to take own medication requires all of the above in addition to the medication authorization signed by the prescribing provider and parent authorizing self- administration of that medication.
  9. For inhaled medication, follow the above procedures and see the Asthma section for specific inhaled medication technique options.

Delegation Considerations

Delegation of oral or inhaled medication administration to ďqualified personnelĒ by an RN must be in accordance with the Regulations of Connecticut State Agencies, Administration of Medications by School Personnel and Administration of Medication During Before- and After-School Programs and School Readiness Programs. It is important to note that according to Section 10-212a-9 of these regulations, paraprofessionals, if approved by the local or regional board of education, in the absence of a school nurse, may only administer medications to a specific student in order to protect that student from harm or death due to a medically diagnosed allergic condition.

Medication Administration Training of School Personnel

The school nurse is responsible for teaching, assessing, documenting the competency of, and providing ongoing supervision to staff members medication administration is delegated to.

The Regulations of Connecticut State Agencies, Section 10-212a-3. Administration of Medications by School Personnel and Administration of Medication During Before- and After-School Programs and School Readiness Programs: Training of school personnel.

Select Nursing Considerations

Each nurse should consider the individual school environment and student population regarding establishing and maintaining a safe medication administration system. There are a variety of ways to store and organize daily and PRN medications so that legal criteria are met and safe access is available.

Nurses who routinely administer medications to the same students need to consider if their system of medication administration is easily understood by another staff member who may need to fill in when they are not available. Some areas to consider are:

  • medication cabinet labels;
  • medication cabinet key identification;
  • medication pouring organizers;
  • the use of medication cards to identify poured medications;
  • the use of student pictures on the back of medication cards or in the medication book;
  • how students know when to come to the health office for medications or if the medication needs to be administered elsewhere in the school;
  • periodic medication counting for each student; and
  • a refill request system to ensure continuity with medications required at school.

References

Bowden, V.R., and Greenberg, C.S. (2008). Pediatric Nursing Procedures, 2nd edition. Philadelphia, PA: Lippincott Williams and Wilkins.

The Regulations of Connecticut State Agencies. Administration of Medications by School Personnel and Administration of Medication During Before- and After-School Programs and School Readiness Programs.

 




Content Last Modified on 7/23/2014 1:31:18 PM