Medication Procedures | Helena Public Schools

Helena Public Schools > Medication Procedures

Medication Procedures

In special cases the school nurse, healthcare provider and parents may agree on a plan for administration of medication during school hours. The parent shall request from the pharmacy a duplicate labelled bottle of the medication if it is deemed necessary that it be taken during school hours. The prescription bottle will be kept at school under the care of school authorities. The pharmacy provided bottle shall contain the name and telephone number of the pharmacy, the student’s name and date of birth, the prescription identification number, the name of the prescribing physician, and the name and dosage of the drug to be given, along with instructions.

Medication administration by school staff may begin up to 24 hours after medication, parent authorizations, and health care provider (HCP) orders are received by the school allowing time for a school nurse to process the new medication intake.

Prior to any medication being given at school the following conditions must be met:

Prescription Medications

All medications must come in an individual pharmacy-labeled container and must include: the name and telephone number of the pharmacy, the student’s name and date of birth, the prescription identification number, the name of the prescribing physician, and the name and dosage of the drug to be given, along with instructions.
Medication cannot be expired.
Documentation deemed appropriate by the school nurse for all prescription medications, must be signed for or verbally authorized to the school nurse by the parent or guardian. Verbal authority must be documented by the school nurse. The school nurse may use “Authorization for Medication to be Given at School” form for documentation.
A signed order from a health care provider with prescriptive authority is required or, per school nurse’s discretion, the pharmacy labeled container is acceptable.
All new medications, changes in medications, changes in dosages, changes in timing or route of administration require both a new prescription from the HCP and parent authorization. Authorization may be a completion of a new Authorization for Medicine to be Given at School form, or Verbal authorization to and documented by the school nurse. An updated medication pharmacy labeled bottle may be used in lieu of a new HCP prescription per school nurse’s discretion.
Authorization granted to administer prescription medication shall be valid for the current school year only and must be renewed annually.

FOR ANY NEW MEDICATION FOR A STUDENT, CHANGE IN MEDICATION, CHANGE IN DOSING, TIMING, ROUTE: CONTACT THE SCHOOL NURSE IMMEDIATELY. ***

Over-the-Counter Medications (OTC)

Pre K- 8th grade students: A licensed health care provider must provide a written order for administration of OTC medication and written or verbal authorization (to the school nurse) from the parent must be on file. The medication must be in the original container. Authorization granted to administer over the counter medication shall be valid for the current school year only and must be renewed annually. Expired medication will not be accepted nor administered.
9th grade -12th grade students: Parents who want the school to manage OTC medication for their high school student must complete an Authorization for Medication to be Given at School form. Authorization granted to administer OTC medication shall be valid for the current school year only and must be renewed annually.
9th grade-12th grade students may keep a small quantity of non-prescribed, parent recommended OTC medication with them and may self-administer, according to package directions.
Parents may be contacted by the School Nurse if concerns arise regarding health issues, need for medication, or inappropriate use.

Alternative Medications

Alternative medications including natural remedies, herbs, vitamins, dietary supplements, homeopathic medication, essential oils, or medications from other countries will not be administered without a licensed health care provider’s authorization. Such medications must be provided to the School Nurse and be labeled by the health care provider or pharmacy with the following information: the student’s name, medication name, route, dose, time of administration, instructions and name of prescribing health care provider.

School District Provided Emergency Medications

In case of an anaphylactic reaction or risk of such a reaction, the School Nurse or delegate may administer emergency oral medication or injectable epinephrine to any student in need thereof on school grounds, in a school building, or at a school function according to a standing order of a chief medical officer for administration of emergency medications. Designated staff members will complete training in the identification of signs and symptoms of anaphylaxis and allergic reactions and administration of emergency medications.

Self-Administration of Emergency Medications

Students with asthma, severe allergies or anaphylaxis may possess and self-administer emergency medication; epinephrine auto-injector, oral antihistamine, or asthma inhaler during the school day, during field trips, during school-sponsored events, or while on a school bus as prescribed by a licensed health care provider.
If provided by the parent, an individual who has executed a caretaker relative educational authorization affidavit, or guardian and in accordance with documents provided by the student’s health care provider, medication for asthma, severe allergy, or anaphylaxis medication may be kept by the student and backup medication may be kept at a student’s school in a predetermined location or locations to which the student has access in the event of an asthma, severe allergy, or anaphylaxis emergency.
Immediately after using epinephrine during school hours, a student shall report to the School Nurse or other adult at the school who shall provide follow-up care, including making a 9-1-1 emergency call.
The school district or nonpublic school and its employees and agents are not liable as a result of any

injury arising from the self-administration of medication by the pupil unless an act or omission is the result of

gross negligence, willful and wanton conduct, or intentional tort.

Authorization granted to a student to possess and self-administer emergency medication for asthma, severe allergies or anaphylaxis episodes shall be valid for the current school year only and must be renewed annually.

Parents must notify the school if their student will be self-administering emergency medication and acknowledge and agree to the liability provisions in MCA 20-5-420, for self-administration of emergency medication.

A completed Montana Authorization to Possess or Self-Administer Asthma, Severe Allergy, or Anaphylaxis Medication (DPHHS form 3416F) form satisfies the following required criteria to obtain the authorization to possess and self-administer medication:

The parents, individual who has executed a caretaker relative authorization affidavit, or guardian must provide a written and signed authorization for the student and sign a statement acknowledging that the District may not incur liability as a result of any injury arising from the self-administration of medication by the pupil and that the parents or guardians shall indemnify and hold harmless the District and its employees and agents against any claims, except a claim based on an act or omission that is the result of gross negligence, willful and wanton conduct, or an intentional tort.
A written authorization from the student’s licensed health care provider containing the name and purpose of the medication, prescribed dosage, and description of time or times at which or the exceptional circumstances under which the medication is to be administered.
Documentation that the student has demonstrated to the health care provider and the school nurse, if available, the skill level necessary to self-administer asthma, severe allergy, or anaphylaxis medication as prescribed.
Documentation that the student’s health care provider has formulated a written treatment plan for managing asthma, severe allergies, or anaphylaxis episodes of the student and for medication use, as prescribed, by the student during school hours

School Nurse to Staff Emergency Medication Delegation for Individual Students

A school nurse may delegate the administration of emergency medications (such as intranasal midazolam, rectal Diastat and injectable Glucagon) per MCA Statute 24.159.1611 as deemed appropriate by the judgement of the school nurse.

Administration of emergency medication is a student specific task, therefore training will be provided by the school nurse.

Staff training will include:

Identification of characteristics of student’s medical condition
Identification of medication order from provider
Location, storage, and disposal of the medication
Appropriate administration of the medication
Documentation of the medication administration
Care of the student before, during and after the administration of medication

Oxygen Use in School

Students requiring Oxygen in school will need to provide a Health Care Provider’s order, “Authorization for Medication to be Given at School” form or parent authorization documentation deemed appropriate by the school nurse.

Continuous Oxygen Use:

A nurse need not be present with students using continuous oxygen as prescribed by a Health Care Provider.

Intermittent Oxygen Use:

Oxygen can be self-administered with staff supervision if student can demonstrate this skill, per medical order.

Oxygen can be initiated by a nurse after assessing the need for oxygen and administered per medical order.

Oxygen can be initiated if a nurse is not present. In order for trained school staff to administer oxygen, the following will be in place:
- The order will include the circumstances under which the oxygen will be administered (symptoms) the rate of flow, how it is to be administered (mask, nasal cannula)
- Oxygen administration can be delegated to trained staff by a school nurse.
- Staff Training will include:
  1. Identification of characteristics of student’s medical condition
  2. Identification of medication order from provider
  3. Location, storage, and disposal of the medication
  4. Appropriate administration of the medication
  5. Documentation of the medication administration
  6. Care of the student before, during and after the administration of medication

Storage and Disposal of Medications

The Superintendent shall arrange for the storage and disposal of medications brought to the school by the parent for the student during the instructional day. Unused, discontinued, or obsolete medication will be returned to the parent or guardian upon notice to that parent or guardian. Access to all stored medications is limited to those individuals authorized to administer medications or assist in the self-administration of medications. Each building shall maintain a list of those persons currently authorized by delegation from a licensed nurse to administer medications.

Controlled Substances

Storage of nonemergency-controlled substances will be locked with key or combination that only delegated staff have access to. Controlled substances will be reconciled monthly at a minimum.