Regulation Glen Ridge Board of Education
M
R5330 ADMINISTRATION OF MEDICATION
A. Definitions
1. "Medication"
means any prescription drug or over-the-counter medicine or nutritional
supplement and includes, but is not limited to, aspirin and cough drops.
2. "Administration"
means the taking of any medication by ingestion, injection, or application to
any part of the body or the giving of direct physical assistance to the person
who is ingesting, injecting, or applying medication.
3. "Self-administration"
means carrying and taking medication without the intervention of the school
nurse, approved through the school district policy and restricted to students
with asthma, other potentially life-threatening illnesses or life-threatening
allergic reaction.
4. "Life-threatening
illness" means an illness or condition that requires an immediate response
to specific symptoms or sequelae (an after effect of
disease or injury) that if left untreated may lead to potential loss of life,
i.e. adrenaline injection in anaphylaxis.
5. "A
pre-filled auto-injector mechanism containing epinephrine" is a medical
device used for the emergency administration of epinephrine to a pupil for
anaphylaxis.
6. "Non-certified
school nurse" means a person who holds a current license as a registered
professional nurse from the State Board of Nursing and is employed by the
district, and who is not certified as a school nurse by the Department of
Education.
7. "Substitute
school nurse" means a person who holds a current license as a registered
professional nurse from the State Board of Nursing and who has been issued a
county substitute certificate to serve as a substitute for a certified school
nurse in accordance with N.J.A.C.6A:9-6.5(i).
8. "School
physician" means a physician with a current license to practice medicine
or osteopathy from the New Jersey Board of Medical Examiners who works under
contract or as an employee of the district.
This physician is referred to as the medical inspector in
N.J.S.A.18A:40-4.1.
9. "Advanced
practice nurse" means a person who holds current certification as nurse
practitioner/clinical nurse specialist from the State Board of Nursing.
10.
“Certified school nurse” means a person who holds a current license as a
registered professional nurse from the State Board of Nursing and an
Educational Services Endorsement, school nurse, or school
nurse/non-instructional from the Department of Education pursuant to N.J.A.C.
6A:9-13.3 and 13.4.
B. Permission
for Administration by a School Nurse or Registered Nurse
1. Permission
for the administration of medication in school or at school-related events will
be given only when it is necessary for the health and safety of the pupil.
2. Medication
will not be administered to a pupil who is physically unfit to attend school or
has a contagious disease. Any such pupil
should not be permitted to attend school and may be excluded in accordance with
Policy No. 8451.
3.
Parent(s) or legal guardian(s) requests for the administration of medication in
school must be made in writing and signed by the parents or legal guardian.
4. The
parent(s) or legal guardian(s) must submit a certified statement written and
signed by the pupil's physician. The
statement must include:
a. The
pupil's name,
b. The
name of the medication,
c. The
purpose of its administration to the pupil for whom
the medication is intended,
d. The
proper timing and dosage of medication,
e. Any
possible side effects of the medication,
f. The
time when the medication will be discontinued,
g. A
statement that the pupil is physically fit to attend school and is free of
contagious disease, and
h. A
statement that the pupil would not be able to attend school if the medication
is not administered during school hours.
5. The
request for the administration of medication must be made by the school nurse
prior to any administration or delivery of medication to the school. The school nurse may consult with the school
physician in making his/her final determination to allow or deny the request.
a. An
approved request will be signed by the school nurse and pupil’s parent(s) or
legal guardian(s).
b.
The parent(s) or legal guardian(s) will be informed of the reason for a denied
request.
C.
Administration of Epinephrine to Pupils
1. The
parent(s) or legal guardian(s) may provide the Superintendent authorization for
the emergency administration of epinephrine via a pre-filled auto-injector
mechanism containing epinephrine to a pupil for anaphylaxis provided that:
a. The
parent(s) or legal guardian(s) provides the Superintendent a written
authorization for the administration of epinephrine with written orders from
the physician or an advanced practice nurse that the pupil requires the
administration of epinephrine for anaphylaxis.
b. The
school nurse has the primary responsibility for the administration of epinephrine. However, the school nurse shall designate, in
consultation with the Board or Superintendent, additional employees of the
district who volunteer to administer epinephrine via a pre-filled auto-injector
mechanism to a pupil when the school nurse is not physically present at the
scene. These volunteers shall be trained
using standardized training protocols established by the New Jersey Department
of Education in consultation with the Department of Health and Senior Services.
The pupil's parent(s) or legal guardian(s) must consent in writing to the administration
of epinephrine via a pre-filled auto-injector mechanism by the designee(s).
c. The
parent(s) or legal guardian(s) must be informed in writing by the Board or
Superintendent that the school district and its employees or agents shall have
no liability as a result of any injury arising from the administration of
epinephrine to the pupil.
d. The
parent(s) or legal guardian(s) must sign a statement acknowledging their
understanding the district shall incur no liability as a result of any injury
arising from the administration of epinephrine via a pre-filled auto-injector
mechanism to the pupil and the parent(s) or legal guardian(s) shall indemnify
and hold harmless the district and its employees or agents against any claims
arising out of the administration of epinephrine via a pre-filled auto-injector
mechanism.
e. The
permission for the emergency administration of epinephrine via a pre-filled
auto-injector mechanism is effective for the school year it is granted and must
be renewed for each subsequent school year upon the fulfillment of the
requirements as outlined in a. through d. above.
f.
The school nurse shall be responsible for the placement of the pupil’s
prescribed epinephrine in a secure but unlocked location easily accessible by
the school nurse and designees to ensure prompt availability in the event of an
allergic emergency at school or at a school function. The location of the epinephrine
shall be indicated on the pupil’s emergency care plan. Back-up epinephrine
shall also be available at the school if needed.
g.
The school nurse or designee shall be promptly available on site at the school
and school-sponsored functions in the event of an allergic reaction.
h.
The school nurse or designee shall arrange for the transportation of the pupil
to a hospital emergency room by emergency services personnel after the
administration of epinephrine, even if the pupil’s symptoms appear to have
resolved.
D. Permission
for Self-Administration of Medication
Permission
for self-administration of medication of a pupil with asthma, other potentially
life-threatening illness, or a life-threatening allergic reaction may be
granted under the following conditions:
1. Parent(s)
or legal guardian(s) of the pupil must provide the Board written authorization
for the self-administration of medication;
2. The
parent(s) or legal guardian(s) of the pupil must also provide the Board with a
signed written certification from the physician of the pupil that the pupil has
asthma or another potentially life threatening illness or is subject to a
life-threatening allergic reaction and is capable of, and has been instructed
in, the proper method of self-administration of medication. The written certification must include:
a. The
pupil's name;
b. The
name of the medication;
c. The
purpose of its administration to the pupil for whom the medication is intended;
d. The
proper timing and dosage of medication;
e. Any
possible side effects of the medication;
f. The
time when the medication will be discontinued;
g. A
statement that the pupil is physically fit to attend school and is free of
contagious disease; and
h. A
statement the medication must be administered during the school day or the
pupil would not be able to attend school.
3. The
parent(s) or legal guardian(s) of the pupil have signed a statement
acknowledging that the school district shall incur no liability as a result of
any injury arising from the self-administration of medication by the pupil and
that the parent(s) or legal guardian(s) shall indemnify and hold harmless the
school district, the Board, and its employees or agents against any claims
arising out of the self-administration of medication by the pupil;
4. The
parent's/legal guardian's written authorization and the physician's written
certification shall be reviewed by the Building Principal with the school nurse
and the school physician. The school
nurse and the school physician must agree the pupil is capable of
self-administration of the medication.
If it is determined the pupil may self-administer medication in
accordance with the request:
a. The
request will be signed by the Principal and given to the school nurse and the
pupil's parent(s) or legal guardian(s),
b. The
parent(s) or legal guardian(s) will be informed of the reason for a denied
request; a denied request may be appealed to the Superintendent,
5. Permission
to self-administer one medication shall not be construed as permission to
self-administer other medication;
6. Permission
shall be effective on the school year for which it is granted and shall be
renewed for each subsequent school year upon fulfillment of the requirements in
1. through 4. above.
E. Custodianship
of Medication
1. Medications
to be administered by the school nurse or a registered nurse
a. All
medications must be delivered to the school by the parent(s) or legal
guardian(s).
b. All
medications must be in the original container, with the prescription
information affixed.
c. The
school nurse shall be custodian of pupils' medication, which will be properly secured.
d. Any
unused medication must be picked up by the pupil's parent(s) or legal
guardian(s).
e. After
reasonable efforts to have the parent(s) or legal guardian(s) retrieve the
medication have failed, any unused medication that remains in the school at the
end of the school year or four school weeks after the pupil stops taking the
medication, whichever first occurs, must be destroyed or discarded by the
school nurse, in accordance with proper medical controls.
2. Medications
to be self-administered by a pupil
a. Time
being of the essence in cases of asthma, other potentially life threatening
illness, or a life-threatening allergic reaction, all medications to be
self-administered by a pupil must be kept in the pupil's possession.
b. No
pupil may possess medication for self-administration unless the proper
permission has been granted by the Principal and a record of the medication is
on file in the office of the school nurse.
c. Pupils
who are permitted to self-administer medications must secure their medication
in such a manner that the medication will not be available to other
pupils. The medication must be in a
sealed container and clearly labeled with the medication name, dosage, and
ordering physician. The medication, if
ingested by someone other than the pupil, shall not cause severe illness or
death.
d. Pupils
who are permitted to self-administer medications shall only have in their
possession the quantity of medication necessary for the time period of the
pupil's school day.
e.
Notwithstanding any other law or regulation, a pupil who is permitted to
self-administer medication in accordance with the provisions of N.J.S.A. 18A:40-12.3
shall be permitted to carry an inhaler or prescribed medication for allergic
reactions, including a pre-filled auto-injector mechanism, at all times,
provided the pupil does not endanger himself or other persons through misuse.
F. Administration
of Medication
1. No
medication shall be administered to or taken by a pupil in school or at a
school-sponsored event except as permitted by Board policy and this regulation.
2. Medication
will only be administered to pupils in school by the school physician, a
certified or non-certified school nurse, substitute school nurse employed by
the district, a pupil who is approved to self-administer in accordance with
N.J.S.A. 18A:40-12.3 and 12.4, and school employees who have been trained and
designated by the certified school nurse to administer epinephrine in an
emergency pursuant to N.J.S.A. 18A:40-12.5 and 12.6.
3. When
practicable, self-administration of medication should be observed by the school
nurse.
4. Pupils
self-administering medication shall report each administration of medication
and any side effects to a teacher, coach, or the individual in charge of the
pupil during school activities. Such
individuals shall report all administrations and any side effects reported or
observed to the school nurse within twenty-four hours.
5. When
a pupil attends a school-sponsored event at which medication may be required
(such as an outdoor field trip or athletic competition) and the school nurse
cannot be in attendance, the pupil's parent(s) or legal guardian(s) will be
invited to attend. If neither the school
nurse nor the parent(s) or legal guardian(s) can attend and the pupil does not
have permission to self administer medication and there is a risk that the
pupil may suffer injury from lack of medication, the pupil may be excused from
the event.
G. Emergencies
Any
medical emergency requiring medication of pupils will be handled in accordance
with Policy No. 8441 and implementing regulations on first aid and, as
appropriate, the school physician’s standing orders for school nurses.
Arrangements will be made to transport a pupil to a hospital emergency room
after the administration of epinephrine in accordance with N.J.S.A.
18A:40-12.5.e.(3).
H. Records
The
school nurse shall include the following in a pupil's health record:
1. The
approved written request for the administration or self administration of
medication;
2. A
record of each instance of the administration of the medication by the school
nurse or a registered nurse;
3. A
record of reports by teachers, coaches, and other individuals in charge of
school activities who report student self administration of medication;
4. Any
side effects that resulted from the administration of medication; and
5. Whether
the supply of medication provided in cases where the medication is to be
administered by the school nurse or a registered nurse was exhausted or the
parent(s) or legal guardian(s) removed the medication or, if the parent(s) or
legal
guardian(s) failed to remove the medication, the medication was
destroyed and the date on which that occurred.
I. Notification
1. The
school nurse may provide the Principal and other teaching staff members
concerned with the pupil's educational progress with information about the
medication and administration when such release of information is in the
pupil's best educational interest.
2. The
school nurse will provide teachers, coaches, and other individuals in charge of
school activities with a list of pupils who have been given permission to self
administer medication.
3. The
school nurse will inform the pupil's parent(s) or legal guardian(s) of any
difficulty in the administration of medication or any side effects.
4. The
school nurse will report to the school physician any pupil who appears to be
adversely affected by the medication.
Adopted:
Revised: 5 December 2005
Revised: 5 November 2007