5.A.20 Administering Medication to Students

Safe Schools

 

 

Administrative Procedure: Administering Medication to Students

 

EFFECTIVE DATE:

September 27, 2006

 

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ADMINISTRATIVE PROCEDURE CODE:

5.A.20

AMENDED DATE:

 

Policy Reference

 

 

Legal Reference

 

 

 

 

 





















The Border Land School Division acknowledges that certain students may require prescribed medication during the school day to function as near to their potential as possible.  The Division also realizes that the administration of prescribed medication by the parent/guardian of the child or by appropriate medical authorities is not always possible at the required times during the school day.

 

The Division will administer prescribed medication only in the manner, and under the conditions outlined in the procedure for administering medication to students.  For students who have life threatening conditions.

 

Administering Medication to Students 

 

Parents must provide the school with a completed Administration of Prescribed Medication form.

  • A copy of the prescription and recommended dosage and any other conditions that apply.
  • Parental permission and signature approving the administration of the prescribed medication.

 

Parents must notify the school immediately if the medication is no longer required and must complete a new Administration of Prescribed Medication form each year and whenever the physician changes the prescription.

 

Schools will designate a specific, locked, and limited access storage space within the school to store the medication.

 

Schools will ensure that there is a copy of the Administration of Prescribed Medication form in the Student Support File (Cumulative File) of the student and that a copy is available for immediate reference by the principal and/or teacher(s) designated by the principal to administer the prescribed medication.

 

Schools may refuse to administer prescribed medication to any child whose parent/guardian has not fully completed the approved Administration of Prescribed Medication form.

 

If a student will not take the prescribed medication, the teacher will notify the principal.  The parent(s)/guardian(s) will be contacted immediately and if they are not available the assistance of a qualified person should be sought.

 

If a substitute teacher is in charge of a student who requires prescribed medication, the principal or designate, who has full knowledge of the facts, will administer the medication.

 

This policy is restricted to the administration of prescribed medication that can be taken orally (e.g. pills) or that can be applied externally.

 

(Administration of Prescribed Oral Medication Form – Student Services Handbook-Appendix 17)

 

ADMINISTRATIONOF URGENTLY REQUIRED MEDICATION/TREATMENT

 

Border Land School Division recognizes that some students attending schools may require medication/treatment for the management of life threatening conditions including, but not limited to acute allergic reactions (anaphylaxis), asthmatic attacks, and response to low blood sugar emergencies.

 

The Board requires schools to respond to these situations in the manner outlined in guidelines and procedures related to this policy and to work with the designated nurse through the Unified Referral Intake System (URIS) to develop health care plans and emergency response plans for these students.

 

Information and Awareness

 

  • Identification of students who may urgently require medication/treatment to school authorities:

     

    • It is the responsibility of the parents/guardians whose child may urgently require medication/treatment to identify their child to the school administrator by completing the health information section of the school registration form and signing Authorization for the Release of Medical Information and Release to Share Information.

        (SSH-13).

  • Identification of students who may urgently require medication/treatment to staff:

     

    • All staff members shall be made aware that a child who may urgently require medication/treatment is attending their school and the child shall be identified, either individually or at a staff meeting at the beginning of the school year.Schools shall list students requiring these supports at the point of registration along with the particular medical needs and share this information with the staff immediately.In circumstances where a substitute teacher is in place, the principal is responsible for the emergency plan.
    • All students identified as having a life-threatening allergy shall have an “allergy alert” attached to their cumulative file. This shall be a red sticker. This “allergy alert” shall remain on the cumulative file throughout the attendance of the student in Border Land School Division.
    • The child’s classroom teacher shall ensure that a copy of the IHCP and/or ERP (SSH-13) is kept in a place where it will be highly visible and readily available to substitute teachers.
    • It is recommended that students wear a medic-alert bracelet that identifies specific medical information.
    • Medications shall be clearly marked with the student’s name.

       

  • Training for teachers and other school staff.

     

    • The school administrator shall ensure that group training provided by a health care professional occurs annually with school personnel.Training of lunch hour supervisors and volunteers will be provided if deemed appropriate by the school administrator in schools where children with life threatening medical conditions are enrolled.

       

    • The Division shall provide opportunities for group training provided by a health care professional for substitute teachers and bus drivers.This shall occur annually.Any new employees/volunteers who may have missed the school-based training could attend these sessions.
    • All staff who may be in a position of responsibility for children with life threatening medical conditions shall receive, from a registered nurse, child specific training related to the medical condition.
    • Parents/guardians of the child with life threatening medical conditions shall ensure that the specific information about their child is made available to school personnel to be included in training session.Parents/guardians are encouraged to attend/participate in training sessions.

       

  • Sharing information with other students and parents/guardians.

     

    • In consultation with parents/guardians and student, the school may identify a student with life threatening medical conditions to classmates who are in direct contact with the child and enlist their understanding and support.This shall be done in a way that is appropriate to the students’ age and maturity, without creating fear and anxiety.

       

  • Maintaining open communication between parents/guardians and the school.
  • The school forwards all health care information to the office of the Assistant Superintendent through the TREVLAC system.
  • The Group B Health Care Procedures form is completed at the Division Office for each identified student.
  • The Assistant Superintendent forwards all Group B Health Care Procedure applications to URIS in order to access funding for training and monitoring of school division staff by a registered nurse.
  • The registered nurse shall review Group B Health Care Procedures for each identified student in order to develop and maintain a written IHCP and /or ERP (SSH-13) for each child requiring assistance by school personnel for Group B health care procedures.
  • For children who are able to accomplish their own Group B health care procedure independently, the registered nurse will develop a child specific Emergency Response Plan (ERP) (SSH-13). These plans are developed by the registered nurse in consultation with parents/guardian, the student, school personnel and, if required, the physician.

     

 

  • The school shall maintain open lines of communication with the parents/guardians of students with life threatening medical conditions.
  • Parents/guardians shall be involved in establishing specific plans for their own children, and may be involved in training staff in emergency procedures.

 

Anaphylaxis Regulation

Avoidance of Allergens

The greatest risk of exposure to allergens is in new situations, or when normal daily routines are interrupted, such as birthday parties, camping, or school trips.  Young children are at greatest risk of accidental exposure, but many allergists believe that more deaths occur among teenagers due to increased independence, peer pressure, and a reluctance to take medication.

 

Avoidance of specific allergens is the cornerstone of management in preventing anaphylaxis.  All of the following strategies shall be considered in the context of the student’s age and maturity as well as the organization and physical layout of the school and the properties of the allergen(s).  As students mature, they shall be expected to take increasing personal responsibility for avoidance of their specific allergen(s). The goal of this regulation is to avoid instances of students experiencing an anaphylaxis episode.  It is recognized, however, that this risk can never be completely eliminated in a school environment.

 

  • Establishing Safe Lunchroom and Eating Area Procedures

    Students with life threatening allergies are dependent upon the school community to minimize the presence of substances to which the student is allergic.  Therefore, it is recommended that the school community:

    • Require students with life threatening allergies to eat only food prepared at home.
    • Discourage the sharing of food, utensils and containers.
    • Encourage the child with life threatening allergies to take the following precautions such as:
      • placing food on wax paper or a paper napkin rather than directly on the desk or table.
      • taking only one item at a time from the lunch bag to prevent cross contamination.
  • Allergens Hidden in School Activities
  • Establish a hand-washing routine before and after eating.
  • Recommend that tables and other eating surfaces are washed clean after eating, using a cleansing agent approved for school use.This is particularly important for students with peanut allergies because of the adhesive nature of peanut butter.

     

     

Not all allergic reactions are a result of exposure at meal times. Children with life threatening allergies may be at risk if involved in garbage disposal, recycling, yard clean-ups, or other activities which could bring them into contact with food wrappers, containers or debris.

 

  • Teachers will attempt to choose products which are safe for all children in the classroom.
  • Teachers will attempt to be aware of the possible allergens present in curricular materials such as:

     

    • craft materials (e.g. play dough, egg cartons, etc.)
    • pets and pet food
    • bean-bag, stuffed toys (peanut shells are sometimes used)
    • counting aids (e.g. beans, peas)
    • toys, books and other items which may have become contaminated in the course of normal use
    • science projects, Human Ecology classes
    • special seasonal activities (e.g. Easter eggs, garden projects, birthday celebrations)

 

  • Allow the child with life threatening allergies to keep the same locker and desk all year in order to prevent accidental contamination, as foods are often stored in lockers and desks.

     

    • Holidays and Special Celebrations

       

      Food is often associated with special occasions and events.  The following procedures will help to protect the child with life threatening allergies:

       

  • Require the child with life threatening allergies to eat food brought from his or her home.
  • Focus on activities rather than food to celebrate special occasions.
    • Field Trips / Excursions

 

        In addition to the usual school safety precautions applying to field

         trips, the following procedures shall be in place to protect the

         child with life threatening allergies:   

 

  • Require all staff and volunteers to be aware of the identity of the child with life threatening allergies, the allergens, symptoms and treatment.
  • Ensure that a staff member (or volunteer, at the discretion of the school administrator) with training in the use of the EpiPen is assigned responsibility for the child with life threatening allergies.A copy of the IHCP and/or ERP shall be carried by the person responsible for administration of the EpiPen.
  • If the risk factors are too great to control, the child with life threatening allergies may be unable to participate in the field trip.Parents/guardians shall be involved in this decision.
  • Teacher/administrators shall ensure that EpiPens are taken on field trips and emergency response plans are in place when planning a trip.There should be reasonable and appropriate access to telephone, cellular telephone, or radio communication during an excursion.

 

  • Anaphylaxis to Insect Venom

     

    Avoidance is more difficult to achieve for this type of allergy, but certain precautions by the schools may be helpful:

     

    • Request removal of insect nests from schooproperty by alerting custodial staff or the Building and Maintenance Department of Border Land School Division.
    • Allow students with life threatening allergies to insect stings to remain indoors for recess during bee/wasp season.
    • Immediately remove a child with an allergy to insect venom from the room if a bee or wasp enters.
    • Ensure proper storage and prompt disposal of garbage.

       

    • Emergency Response Protocol
    •  

       

      Even when precautions are taken, a student with life threatening allergies may come into contact with an allergen while at school.  A separate emergency plan shall be developed for each child’s parents/guardians and a registered nurse, as provided by URIS, and kept in a readily accessible location.  A copy of the plan must be kept in the substitute teacher file.

       

  • Emergency Plans

 

Epinephrine is the treatment for an anaphylactic reaction.  There are no contra-indications to the use of epinephrine for a life threatening allergic reaction.  Epinephrine must be administered as early as possible after the onset of symptoms of severe allergic response.

 

  • The emergency plan will include the following:
    • Communicate the emergency rapidly to a staff person who is trained in the use of the Adrenaline Auto-injector (EpiPen).
    • Administer the EpiPen (NOTE: Although most children with life threatening allergies learn to administer their own medication by about age 8, individuals of any age may require help during a reaction because of the rapid

                              progression of symptoms, or because of the stress of the

                              situation.   Adult supervision is required).

  • Telephone 911 and inform the emergency operator that a child is having an anaphylactic reaction or transport the child immediately to the nearest hospital.
  • Transport the child to hospital at once by ambulance or vehicle.
  • Provide a copy of the IHCP and/or ERP as well as the used EpiPen to the ambulance or hospital attendants.
  • Telephone the parents/guardians of the child.
  • Implement Universal Precautions as appropriate.

     

  • Location of Adrenaline Auto-injectors (EpiPens)

     

    • Students shall carry their own EpiPen on their person at all time with instructions for use.If the student is not developmentally able to carry the EpiPen, it will be kept in an unlocked, safe, easily accessible location, and a staff member will be designated its responsibility.
    • Where a question arises regarding the urgency of medication or the capability of a student, the registered nurse in consultation with parent/guardian, physician, and school personnel shall develop an appropriate plan.
    • It is recommended that parents/guardians supply an extra EpiPen to be kept in the school office for emergency situations.This extra EpiPen shall be kept in a covered and secured area, but unlocked for quick access.
    • Bus drivers shall be aware of location of EpiPens for students on their buses.
  • Review Process

              

    School emergency procedures for each student with life threatening allergies shall be reviewed annually at the beginning of the school year with staff and parents/guardians.  In the event of an emergency response, an immediate evaluation of the procedure shall be undertaken.

     

     

  • Division of Responsibilities
  •  

     

    Ensuring the safety of children with life threatening allergies in a school setting depends upon the understanding and support of the entire school community.  To minimize the risk of exposure, and to ensure rapid response to emergency, parents/guardians, students and school personnel must all understand and fulfill their responsibilities.

     

  • Responsibilities of the Parents/Guardians of a Child with Life Threatening Allergies

     

    • Inform the school of their child’s allergies.
    • Provide the school with physician’s instructions for administering medication by completing the health information section of the school registration form.
    • Sign the Authorization for the Release of Medical Information and the Release to Share Information (SSH -13).
    • Provide the school with a clearly labeled, current EpiPen(s).
    • Provide support to school and teachers as required.
    • If possible and appropriate, supply information for school publications including:
      • Items to avoid that may contain allergen(s);
  • Responsibilities of the Assistant Superintendent (or Designate)

     

  • Responsibilities of the Registered Nurse

     

  • Responsibilities of the Child with life threatening allergy (as they are developmentally able)

     

    • Take as much responsibility as possible for avoiding allergens, including checking labels and monitoring intake.
    • Eat only foods brought from home.
    • Wash hands before and after eating.
    • Learn to recognize symptoms of an anaphylactic reaction.
    • Promptly inform an adult, as soon as accidental exposure occurs or symptoms appear.
    • Keep an EpiPen on his/her person at all times (fanny pack), and

                                           know how to use the EpiPen.

       

  • Responsibilities of All Parents/Guardians

     

    • Follow the Border Land School Division Anaphylaxis Regulation.
    • Support requests from school to eliminate allergens from packed lunches and snacks and, if appropriate, participate in parent/guardian information sessions.
    • Encourage children to respect the needs of children with life threatening allergies.
    • Inform the teacher prior to distribution of food products to any children in the school.

       

  • Responsibilities of All Children in the Class

     

    • Avoid sharing food, especially with children with known risk of anaphylaxis.
    • Follow school rules about keeping allergens out of the classroom and washing hands.
    • Refrain from bullying or teasing a child with a known risk of anaphylaxis.

       

  • Responsibilities of the Transportation Coordinator

     

    • Maintain regular contact with the Assistant Superintendent regarding students identified with life threatening conditions, including anaphylaxis.
    • Inform bus drivers who provide transportation for these students.
    • Provide bus drivers with the individual health plan and emergency response plan for these students.
    • In cooperation with the URIS nurse, provide annual training for bus drivers and alternates regarding life-threatening conditions including anaphylaxis and the appropriate responses.

       

  • Responsibilities of the Bus Driver

     

    • Keep appropriate records of students on his/her bus who have life threatening conditions, including anaphylaxis.
    • Attend annual training regarding health plans and emergency response plans for these students.
    • Be aware of conditions that may put these students at risk.
    • Respond to student in need of emergency medical attention following health plan guidelines.
    • Respond appropriately in the event of a health emergency of a child under his/her supervision.
  • Responsibilities of Substitute Teachers
  • Provide safe foods for special occasions.
  • Teach their child:
    • To recognize the first symptoms of an anaphylactic reaction.
    • To communicate clearly when he or she feels a reaction starting.
    • To carry his/her own EpiPen.
    • If not carried on the person, to know where medication is kept, and who can get it.
    • Not to share snacks, lunches or drinks.
    • To understand the importance of hand-washing.
    • To cope with teasing and being left out
    • To report bullying and threats to an adult in authority.
    • To take as much responsibility as possible for his/her own safety.

       

  • Consider a medic alert bracelet for their child.

     

    • Responsibilities of the Administrator

       

      • Assist with the development and implementation of regulations and procedures for reducing risk in classrooms and common areas.
      • Work as closely as possible with the parents/guardians of a child with life threatening allergies.
      • Ensure that the parents/guardians have completed Authorization for the Release of Medical Information and the Release to Share Information (SSH-Appendix13-1).
      • Notify the staff of the child with life threatening allergies, their allergens and the avoidance and treatment strategies.
  • Post allergy-alert information including a photo-poster which identifies each student in the staff room and/or office.
  • Maintain up-to-date emergency contacts and telephone numbers.
  • Ensure that the “allergy alert” is attached to the cumulative file.
  • Ensure that all staff and, where appropriate, lunch hour supervisors, bus drivers, and volunteers have received training related to life threatening allergies.
  • Notify parents/guardians that training has been completed.
  • Ensure that all substitute teachers are informed of the presence of a child with life threatening allergies and that appropriate support/response is available should an emergency occur.
  • Discuss with parent/guardian/child the option of informing other parents/guardians that a child with life threatening allergies has direct contact with their child and ask for their support and cooperation.
  • If not deemed appropriate for the child to carry an EpiPen, ensure

       that it is kept in an unlocked, safe, easily accessible location and  

       that a staff member is designated its responsibility.

    • Establish safe procedures for field trips and extra-curricular

               activities.

    • Develop a school plan for reducing risk in classrooms and common areas.
    • Ensure that the substitute teacher files contain a copy of this emergency plan.

       

  • Request and compile all forms for Group B Health Care Procedures (SSH-13) and Authorization for the Release of Medical Information (SSH-13) from all schools.
  • Apply to URIS for support of a registered nurse who will train and monitor personnel involved with a child with life threatening allergies and who will develop IHCP and/or ERP) (SSH-13-4&5) on an annual basis.
  • Notify the Transportation Coordinator regarding bus students who have life threatening conditions including anaphylaxis.
  • Work in co-operation with the Transportation Coordinator to access training for bus drivers and alternates.
  • Communicate with substitute teachers regarding training needs in this regard.

     

    • Responsibilities of the Classroom Teacher

       

      • Leave information in an organized, prominent and accessible format for substitute teacher.
      • Display in the classroom (with parent/guardian/child approval), a photo-poster identifying the child with life threatening allergies.
      • Discuss anaphylaxis in age appropriate terms with the class.
      • Encourage students not to share lunches or trade snacks.
      • Choose products which are safe for all children in the class.
      • Instruct children with life threatening allergies to eat only what he/she brings from home.
      • Reinforce hand washing before and after eating.
      • Where appropriate, facilitate communication with other parents/guardians.
      • Follow the Border Land School Division Anaphylaxis Regulation for reducing risk of exposure to allergens.
      • Ensure that EpiPens are taken on field trips and emergency response plans are in place when planning the trip.
      • Consult with parents/guardians when planning activities such as field trips, art and human ecology projects in order that alternate plans can be developed if necessary.
  • Review Group B Health Care Procedures (SSH-13-3) which identify children with life threatening allergies after URIS approval has been received.
  • Consult with and provide information to parents/guardians, students and school personnel.
  • Develop an IHCP and/or ERP (SSH-13-4&5) for the child with known risk of anaphylaxis.
  • Provide child specific training and ongoing monitoring to personnel involved with children with known risk of anaphylaxis.

     

    • Responsibilities of the Public Health Nurse (when available)

       

  • Review Group B Health Care Procedures (SSH-13-3) that

          identify children with life threatening allergies after URIS

          approval has been received.

  • Consult with and provide information to parents/guardians, students and school personnel.
  • Develop an IHCP and/or ERP (SSH-13-4&5) for the child with known risk of anaphylaxis.
  • Provide child specific training and ongoing monitoring to personnel involved with children with known risk of anaphylaxis.
    • Coordinate with school administrator, and parents/guardians in the choice and implementation of strategies that support the needs of students with life threatening allergies.
    • Facilitate and/or provide education and support to school personnel and community members involved with children with known risk of anaphylaxis.

       

 

  • Attend school based or divisional sessions on responding to students with life threatening conditions as required.
  • Enquire as to whether a student in an assigned classroom has a life threatening condition.
  • Enquire as to who is the emergency responder in the school.
  • In the case of anaphylaxis, be aware of the location of the EpiPen.