Spearfish School District 40-2
GUIDELINES FOR GIVING MEDICATIONS BY SECRETARIES
NON-LICENSED ASSISTIVE PERSONNEL
1. The Board of Nursing has determined that administration of medications is a nursing function
and has set forth rules that allow a licensed nurse to delegate the administration of medications to non-licensed assistive personnel who have a minimum of a high school education or the equivalent and who have completed training as outlined in the rules. It is through the act of the nurse delegating this function that a non-licensed individual has the legal authority to perform this function.
Medication administration may be delegated only to those individuals who have successfully completed a training program approved by the South Dakota Board of Nursing. Only those completing the training may administer medications under the supervision of a licensed nurse.
The following tasks may be legally delegated by a nurse to those individuals who have successfully completed the training program:
a. Administration of medications by oral, rectal or topical route.
b. Measuring of a prescribed amount of liquid medication or crushing a tablet for administration, if the licensed nurse has calculated the dose.
c. Administration of Schedule II substances (ex. Ritalin) which have been prescribed and labeled in a container for a specific client.
2. The initial form required is the Request to Administer Medication and Release Agreement (Form 5310.1FM) with the attached Medication Administration form (Form 5310.1FM). ABSOLUTELY NO MEDICATION MAY BE GIVEN WITHOUT WRITTEN PERMISSION ON THIS FORM. This form will be included in the initial welcome-to-school folder or handout with a note of explanation. It is important to inform new families of the medication requirements when they register for school.
Verbal or telephone orders are another option but require a registered nurse. Only the supervising school nurse can take verbal orders from the Health Care Provider regarding medication. Such orders must be followed by a hard copy to verify the order within 24 hours. All orders should be clear and specific. If questions exist, they should be clarified through the supervising nurse.
3. Receiving the order and medication
Review the form. Your responsibility in receiving the form (form 5310.1FM) includes a review of the form to see that it is complete. If signatures or information is missing, parents should be notified of the missing data. If specific administration information is missing from the form, the nurse may choose to contact the Health Care Provider if the information is something that only the Health Care Provider can provide. The medication bottle should be compared with the written order to confirm they are consistent and accurate. The label on the bottle will indicate the dosage of medication given for the day. The written order should indicate for which dose the school is responsible. The label may indicate more doses but the written order should indicate which of those doses the school is authorized to administer.
Verify the number of pills, tablets, etc. When medication is received, count the medication with another person as soon as possible. The other person could be the parent or another staff member. Complete the area on the form that indicates the number of pills received. Both parties are to sign in the appropriate area. The purpose of counting medications is to verify how many pills were received at school, if parents question the need for more, and to provide assurance that pills are not lost, stolen, used by another or misplaced.
Contact the supervising school nurse. After counting the medication and reviewing the form for completeness, contact the school nurse for further direction. The nurse may wish to review with you over the telephone the medication order or the nurse may choose to come and review the order personally. In some situations, the nurse may ask you to go ahead with the order and review the order with her only when she comes to the building.
4. The child must come to the office at the time the child is to receive medication. Sometimes young children may need to be reminded for a few days by their teacher. If a child misses a
dose, the school secretary or nurse will notify the parent.
a. Children in resource rooms will be accompanied to the office to receive their medication from trained personnel.
b. Medication can be safely administered up to one-half hour before or after the prescribed time.
c. For students who are participating in school activities outside the building (i.e., field trips or athletic participation): 1) the parent/guardian or responsible designated person is required to bring the appropriate dosage in a sealed envelope with instructions for administering the appropriate medication and dosage and signed by the parent/guardian or responsible designated person; 2) the secretary will provide the appropriate medication and dosage to the appropriate school personnel who will administer the medication/dosage to the student.
5. If there is an increase or decrease or change of medication a new Request to Administer
Medication and Release Agreement (Form 5310.1FM) shall be completed by the parent/guardian or responsible designated person.
6. Use the Medication Administration form (Form 5310.1FM) to document giving medication to the child and be certain the person giving the medication signs it. Time should be included. It is best practice to indicate on the medication form when and why a medication has not been given as ordered (i.e. vacation, ill, snow day, error-forgot, accident report written, etc.).
7. If you have any concerns about giving any child any medication, please visit with the district nurse.
8. All medications must be stored in a locked cabinet or refrigerator.
9. Errors and accident reports. If an error occurs it must be called to the attention of the supervising school nurse as soon as it is recognized. Errors may be forgetting to administer a medication, giving the wrong dose to the right child, giving the wrong medication to a child, giving the right medication to the wrong child, etc. In most cases, the error will not cause significant harm to the child but each incidence must be investigated to determine if a situation does require further action. It is important that all errors be reported to the supervising nurse as soon as they are recognized so the appropriate action can be determined. Depending on the situation, the physician may need to be called. Parents should always be notified. In some cases, parents may need to adjust the next dose of medication, observe for reactions, etc. An Incident Report (Form 5310.3FM) should be completed, signed by the principal and sent to the supervising nurse.
Approved August 12, 1996
Revised December 14, 1998
Revised February 14, 2000
Revision First Reading April 14, 2008