Medication Administration Policy

Written Orders, Appropriate Containers, Labels, and Information

A. Medication Orders

Medication shall not be administered to any student without a completed Medication Order from a physician or dentist licensed to practice medicine in the state of Louisiana or any other state of the United States, or any other authorized prescriber, and a letter of request and authorization from the student’s parent or guardian. The following information shall be included:

1. The student’s name
2. The name and signature of the physician, dentist, or other authorized prescriber
3. Prescriber’s business address, office phone number, and emergency phone numbers
4. Relevant diagnosis
5. Name, amount of each school dose, time of school administration, route of medication, and reason for use
6. A written statement of the desired effects and the child-specific potential adverse effects

B. Medication Containers

Medication shall be provided to the school by the parent or legal guardian in a container that meets acceptable pharmaceutical standards and shall include the following information:

1. Name of pharmacy
2. Address and telephone number of pharmacy
3. Prescription number
4. Date dispensed
5. Name of student
6. Clear directions for use, including route, frequency, and other as indicated
7. Drug name and strength
8. Last name and initial of pharmacist
9. Cautionary auxiliary labels, if applicable
10. Prescriber’s name

Labels of prepackaged medications, when dispensed, shall also contain: drug name, dosage form, strength, quantity, name of manufacturer and/or distributor, and manufacturer’s lot or batch number.

Administration of Medication — General Provisions

1. Once trained, the school employee who administers medication may not decline to perform such service at the time indicated, unless exempted in writing by the MD or RN.
2. During the period when the medication is administered, the person administering medication must be relieved of all other duties. This requirement does not include the required observation period.
3. Except in the case of a trained unlicensed diabetes care assistant or in life-threatening situations, trained unlicensed school personnel may not administer injectable medications.
4. All medications must be stored in a secured locked area or locked drawer with limited access except by authorized trained school personnel.
5. Only oral, inhalant, topical ointment for diaper rash, and emergency medications may be administered at school by unlicensed, but trained, school personnel. Under special circumstances, other medications may be administered as approved by the school nurse.
6. Each student must be observed by a school employee for a period of 45 minutes following the administration of medication. This observation may occur during instruction time.
7. School medication orders shall be limited to medication which cannot be administered before or after school hours.

Principal Responsibilities

The principal shall designate at least two (2) employees to receive training and administer medications in each school.

Teacher Responsibilities

The classroom teacher who is not otherwise previously contractually required shall not be assigned to administer medications to students. A teacher may request in writing to volunteer to administer medications to his or her own students. The administration of medications shall not be a condition of employment of teachers employed subsequent to July 1, 1994. A regular education teacher who is assigned an exceptional child shall not be required to administer medications.

School Nurse Responsibilities

1. The school nurse, in collaboration with the principal, shall supervise the implementation of the school policies for the administration of medications in schools to ensure the safety, health, and welfare of the students.
2. The school nurse shall be responsible for the training of non-medical personnel designated by each principal to administer medications. The training must be at least six (6) hours and include:
   1. Proper procedures for administration of medications including controlled substances
   2. Storage and disposal of medications
   3. Appropriate and correct record keeping
   4. Appropriate actions when unusual circumstances or medication reactions occur
   5. Appropriate use of resources

Parent and Legal Guardian Responsibilities

A. Required Documentation

The parent or legal guardian who wishes medication administered to his or her child shall provide the following:

1. A letter of request and authorization containing the student’s name; clear instructions for school administration; prescription number, if any; current date; relevant diagnosis; name, amount, time, and route of medication; prescriber’s name; parent or guardian’s printed name and signature; emergency phone number; and a statement granting or withholding release of medical information.
2. A written order for each medication to be given at school, including annual renewals at the beginning of the school year. Orders dated before July of that school year shall not be accepted. No corrections shall be accepted on the Medication Order form. Alteration of this form or falsification of the signature is grounds for prosecution. Orders for multiple medications on the same form, incomplete forms, or forms with a prescriber’s stamp shall not be accepted. Faxed orders may be accepted; original orders must be received within five (5) business days.
3. A prescription for all medications to be administered at school, including medications ordinarily available over-the-counter. Only the prescriber or their staff may write on the Medication Order form.
4. A list of all medications the student is currently receiving at home and at school, if not contrary to confidentiality requirements.
5. A list of names and telephone numbers of persons to be notified in case of a medication emergency.
6. Arrangements for safe delivery of the medication to and from school in a properly labeled container, delivered by a responsible adult. Parents should obtain two containers from the pharmacist — one for home and one for school. If medication is not properly labeled and does not match the physician’s order exactly, it will not be administered.

Additional Requirements

• All aerosol medications shall be delivered to the school in pre-measured dosage.
• Provide no more than a thirty-five (35) school day supply of medication in a properly labeled container.
• The initial dose of a medication shall be administered by the parent or legal guardian outside the school with sufficient time for observation for adverse reactions.

B. Parent Cooperation

The parent or legal guardian shall work with designated personnel as follows:

• Cooperate in counting the medication with the designated school personnel who receives it and sign the Drug Receipt form.
• Cooperate with school staff to provide for safe, appropriate administration of medications, including positioning and suggestions for liquids or foods to be given with the medication.
• Assist in the development of the emergency plan for the student.
• Comply with written and verbal communication regarding school policies.
• Grant permission for school nurse, physician, or prescriber consultation.
• Remove or give permission to destroy unused, contaminated, discontinued, or out-of-date medications according to school guidelines.

Student Self-Medication

Only those medical conditions which require immediate access to medications to prevent a life-threatening or potentially debilitating situation shall be considered for self-administration of medication. Compliance with the school policy for a drug-free zone shall also be met if possible.

Asthma, Diabetes, or Use of Auto-Injectable Epinephrine

Self-administration of medications by a student with asthma or diabetes, or the use of auto-injectable epinephrine by a student at risk of anaphylaxis, shall be permitted by the School Board, provided the student’s parent or legal guardian provides the following documentation:

1. Written authorization for the student to carry and self-administer such prescribed medications.
2. Written certification from a licensed medical physician or other authorized prescriber that the student: (1) has asthma, diabetes, or is at risk of having anaphylaxis; and (2) has received instruction in the proper method of self-administration.
3. A written treatment plan from the student’s licensed physician or prescriber for managing asthma, diabetes, or anaphylactic episodes, signed by the student, the parent or legal guardian, and the physician. The plan shall contain: the name, purpose, and prescribed dosage of the medications; the time(s) the medications are to be administered and under what additional circumstances; and the length of time for which the medications are prescribed.
4. Any other documentation required by the School Board.

Permission for self-administration shall be effective only for the school year in which it is granted and must be renewed each subsequent school year.

Other Permitted Medications

Self-administration of other medications by a student may be permitted by the School Board, provided that: a Medication Order and parental consent are on file; the school nurse has evaluated the situation and deemed it safe and appropriate; the principal and appropriate staff are informed; the medication is handled safely; a safe storage place has been determined; a backup supply is available if needed; and the student records all self-administration dates and times in the medication log kept in the main office.

Acceptable School Medications

School medication orders shall be limited to medication which cannot be administered before or after school hours. Parents may come to school and administer medication to their children at any time during the school day. Medications which may be considered acceptable under this policy include:

1. Medication to modify behavior (e.g., Ritalin, when the sustained action form is not effective)
2. Severe allergic reactions — must have specific written instructions from a physician
3. Anticonvulsive medication
4. Medication for asthma or diabetes
5. Medication given in extenuating circumstances
6. Non-prescription (over-the-counter) drugs — only if medical certification of extenuating circumstances and prescription is obtained
7. Antibiotics and other short-term medications — will not be given at school unless so ordered by a physician, dentist, or authorized prescriber
8. The school nurse or trained school employee shall have the authority to administer auto-injectable epinephrine to a student believed to be having an anaphylactic reaction, whether or not the student has a prescription for epinephrine. At least one employee at each school shall receive training in the administration of epinephrine.
9. Other specific illnesses that require medication
10. The school nurse shall have the authority to maintain a supply of naloxone or other opioid antagonists per La. Rev. Stat. Ann. § 17:436.1(M). The school nurse or trained school personnel may administer naloxone to any student or other person on school grounds in the event of an actual or perceived opioid emergency.

Diabetes

Each student with diabetes who seeks care for his or her diabetes while at school or during a school-related activity shall submit a diabetes management and treatment plan on an annual basis. Such plan shall be developed by a physician licensed in Louisiana or any other U.S. state selected by the parent or legal guardian.

The diabetes management and treatment plan shall be kept on file at the school and shall contain: a detailed evaluation of the student’s level of understanding of his or her condition and ability to self-manage; the diabetes-related healthcare services the student may receive or self-administer; a timetable including dosage instructions for any diabetes medications; and the signatures of the student (if age appropriate), the parent or legal guardian, and the physician.

The plan shall be submitted annually by the parent or legal guardian to the principal and shall be reviewed by school personnel either prior to or within five (5) days after the beginning of each school year, upon enrollment, or as soon as practicable following diagnosis.

Upon receipt of the plan, the school nurse shall conduct a nursing assessment and develop an Individualized Healthcare Plan (IHP) within five (5) school days, implementing it within ten (10) school days of receipt. The parent or legal guardian shall be responsible for all care related to the student’s diabetes management plan until the IHP is developed, agreed to, signed, and put into place by the school nurse.

The School Board may utilize an unlicensed diabetes care assistant to provide appropriate care to a diabetic student in accordance with the student’s plan, the IHP, and BESE regulations.

Classroom Storage and Administration of Auto-Injectable Epinephrine by Teachers

The School Board shall allow a supply of auto-injectable epinephrine to be maintained in a secure location in each classroom assigned to a student who is deemed by his or her physician to be at high risk for anaphylactic reaction and incapable of self-administration.

The student’s parent or legal guardian shall annually provide the school with: the supply of auto-injectable epinephrine; written authorization for the student to be administered the medication; written certification from the student’s physician that the student is at high risk of anaphylaxis and incapable of self-administration; and a written treatment plan for managing anaphylactic episodes.

The teacher in each classroom where auto-injectable epinephrine is stored shall be provided information regarding accessing and administering epinephrine, the signs and symptoms of anaphylactic reactions, and specific information regarding the condition, care, and treatment of the student assigned to that classroom.

This policy shall be included in the student handbook of each school and posted on each school’s website. The policy shall also be disclosed to any parent or legal guardian who notifies the school in writing that the student has a condition which puts them at risk of anaphylaxis.

Administration of Medication on Field Trips and Other Extra-Curricular Activities

If a student with an identified medical need is to attend a field trip or other school-sponsored activity, parents shall be notified to determine if any medication must be administered during the activity. If so, the parent or legal guardian shall accompany the student to administer any medication.

If the parent or legal guardian cannot attend, they shall request in writing that the medication be administered by a non-School Board employee designated by the parent, or by a trained person designated by the School Board. The request shall include supporting documentation as outlined in this policy and shall grant permission to the designee to administer the medication. If no non-School Board employee is designated, the School Board shall assign a trained employee to accompany the student.

Extended Day Care

In the event that a student attends extended day care and requires medication outside school hours (before or after school), medication orders that include the dosage(s), time(s), and medication(s) shall be obtained from the prescriber before any medication may be administered by properly trained personnel.

Sunscreen

Sunscreen means a compound topically applied to prevent sunburn and shall not be considered medication for purposes of this policy. A student may possess and self-apply sunscreen at school, on a school bus, or at a school-sponsored function without parental consent or physician authorization.

If a student is unable to self-apply sunscreen, a school employee may volunteer to apply the sunscreen, provided the parent or legal guardian has given written consent for this application. Neither the School Board nor the employee shall be held liable for any adverse reaction relating to the application or cessation of application.

Student Confidentiality

All student information shall be kept confidential. The parent or legal guardian shall be required to sign the Authorization for Release of Confidential Information form so that health information can be shared between the School Board and health care providers, such as hospitals, physicians, service agencies, the school nurse, and other health providers.