I-1.3 STUDENT MEDICATIONS

Chapter I - Health and Safety

Part 1.0 Student Health

Section 1.3 Student Medications

Policy Statement:

1. Students that are administered, self-administer, retain, or possess medications, whether prescription or non-prescription, are prohibited from sharing, selling, or distributing medications for any reason. The District recommends that parents counsel students regarding the dangers of using medications in a manner that is not prescribed by a physician or in a manner other than as directed by the manufacturer.
2. "Medication" under this policy refers to a substance used to treat a medical condition. For the purposes of this policy, that term does not include prohibited or illegal substances, nor does it refer to personal care products such as lip balm, lotion, contact solution, cough drops, etc.

American Preparatory Academy recognizes that some students need to receive medication during the school day and delegates to the Administration appropriate guidelines for administering medication to students in accordance with Utah Code 53G-9-502 et seq. and for the self-administration of medication by the student.

General Provisions

School personnel may administer medication to students while the student is under the supervision of the school in accordance with this policy and Utah Code 53G-9-502 et seq.

Self-administration of medication by students shall be allowed under the procedures specified in Self-Administration of Medication (below)

School-Administered Medication

1. School personnel may administer prescription medication to a student during the regular school day only when the medication has been prescribed by the student's licensed health care provider and the school Administration received:
2. A current Health Alert Form signed by the student's parent or legal guardian; and
3. A current Medication Authorization Form completed by the health care provider that includes the following:
   1. A statement that administration of medication by school employees during periods when the student is under the control of the school is medically necessary, and
   2. A statement that describes the route, dosage, time schedule for administration, name of medication, name of student diagnosis, side effects, and duration of the treatment.
4. The Medication Authorization Form must be resubmitted at the beginning of each school year the medication is administered, and as medication is prescribed or changed.
5. Oral, topical, inhalant medication or injectable epinephrine may be administered by school personnel who have been certified by the school nurse to administer medication if the provisions outlined in section ***  have been met.

Medications requiring other routes of administration will not be given by school personnel, unless delegated by a registered nurse in accordance with the Utah Nurse Practice Act (Rule R156-31b).

1. All medication that is to be given at school must be furnished by the parent or guardian and delivered to the school by a responsible adult.
2. All prescription medication must be in the original container labeled by the pharmacy with the name of the student, the name of the health care provider, the name of the medication, the dosage, the time the medication is administered, and the route.   All the medication on the label must be identical to the information specified on the Medication Authorization Form signed by the health care provider.
3. Non-prescription (over-the-counter) medication must be submitted in the original container and be labeled with the student's name.  The name of the medication and dosage indicated on the label must be identical to the name of the medication and dosage specified on the Medication Authorization Form.
4. All school personnel who are assigned and/or authorized to administer student medication must receive yearly in-service training and certification provided by the school nurse.
5. A record including the name of medication, the dosage of medication, and the time of day it was administered must be kept for each student receiving medication at school.  The person administering the medication must initial the record each time medication is given.
6. School personnel who administer medication to students in compliance with the Medication Authorization Form signed by the health care provider are not liable, civilly or criminally, for any adverse reaction suffered by the student as a result of taking the medication or the school's discontinuing the administration of the medication under these guidelines.
7. Unused or discontinued medication must be picked up by a responsible adult within two weeks following the last dose administered.  All medication must also be picked up by a responsible adult at the end of the school year.  Medication remaining at the school after this time should be destroyed according to directives by the District nurse.
8. Parents shall administer the first dose of any medication (either over the counter or prescription) at home to monitor any potentially adverse reactions.
9. Medication that was previously given at school, and requires a dosage change, is considered a new medication;  best practice dictates that parents would administer the first dosage. 
10. Siblings in elementary school may share the same medication such as a metered dose inhaler, epi-pen, over the counter medications, and prescription medications provided:
11. If school personnel receive a medication for which they are unsure or are unfamiliar, the assigned school nurse should be contacted to verify.
12. School personnel may only administer medications according to this policy.   

Self-Administration of Medication

The Administration authorizes the following administrative policy provisions for self-administration of medication by students.

1. Elementary and secondary students may retain and self-administer insulin, or asthma medication (inhaler) if a parent/guardian completes a current Authorization form that includes a statement from the student's health care provider (physician, dentist, nurse practitioner, or physician's assistant) that the student is capable of carrying and 4 self-administering his or her own medication, and that it is medically necessary for them to keep the medication at all times.
2. The school nurse and administration will determine whether or not a student qualifies for self-carrying and administering a medication. Students that will be considered for self-carrying and administration of their medications are ten years old and older. Those younger than ten years may be considered per the student, health concerns, and medication needed to be administered.
3.  Secondary students may retain and self-administer medications subject to the following guidelines:
   1. Prescription medications may be retained and self-administered provided that students shall not possess more than one day's dose of prescription or over-the-counter medication at school.
   2. Prescription and non-prescription medications shall be taken only as directed by a prescription or manufacturer's directions.
   3. Prescription and non-prescription medication, shall not be sold, shared, or distributed to others. Distribution of any drug or medication from one student to another will be considered Dangerous and Disruptive Conduct and shall be dealt with according to the provisions of APA's Code of Conduct Policy.
   4. Authorization for the ability to carry and/or self-administer medication may be denied or withdrawn by the school director after consultation with the assigned school nurse at any time following actual notice to the student's parent or guardian.

Specific Medication Laws

Under the direction of the school nurse and consistent with the other provisions of this policy, schools shall abide by state laws and rules related to specific medication,including those medications addressed in this section. In particular, District nurses shall provide appropriate training to school personnel regarding procedures of administration of identified medications, emergency response protocols, appropriate notice to parents/guardians, proper documentation, and other requirements.

Certain medications are not to be delegated by law to unlicensed personnel.  According to the Nurse Practice Act (R156-31b-701a), the licensed nurse shall not delegate any task requiring the specialized knowledge, judgment and skill of a licensed nurse to unlicensed assistive personnel.  Delegation of certain medications will therefore be determined on a case by case basis to determine medical necessity, safety, and feasibility of administration based on the aforementioned criteria.  The following may be delegated administration medications:

1. Asthma Medications
   1. Asthma medications shall be administered in accordance to Utah Code, 53G-9-503.
2. Epinephrine Auto-Injector
   1. Epinephrine auto-injectors shall be administered in accordance to Utah Code, 26-41-101.
   2. If epinephrine is administered to a student, 911 shall be called and the parent/guardian shall be notified.
3. Glucagon-Diabetes Emergency Medication
   1. Glucagon shall be administered in accordance to Utah Code, 53A-11-603.
   2. If glucagon is administered to a student, 911 shall be called and the parent/guardian shall be notified.
4. Sunscreen 
   1. Students may administer sunscreen in accordance with Utah Code 53G-9-208.
   2. If the student is unable to self-apply sunscreen, a volunteer or school employee may administer it with written parent/guardian permission. 
5. Emergency Seizure Medication

Upon request from a parent, the school will create a Seizure Rescue Authorization in the form of a 504 plan.

The 504 plan will include the following information:

1. Name the medication, dose, instructions for administration.
2. Ensure that it is prescribed – check box and signature
3. Assurance listed and signed that the parents have previously administered it unsupervised without complication.
4. A request from the parents that the school identify and train volunteers who will receive training and be willing to administer rescue medication.
5. An authorization from the school and the parent to the volunteers giving them the permission to administer the medication according to the 504.

Emergency seizure medications shall only be administered in accordance with Utah Code, 53A-11-603.5 and Utah Administrative Code, R156-31b- 701a.

1. If seizures are full-body, tonic-clonic, emergency seizure medication may be administered by a volunteer trained by a District nurse as outlined in the student's individualized health care plan.
2. The student must have received a first dose of this medication outside school in a non-medically-supervised setting and ceased having a full body, prolonged, or convulsive seizure without other complications.
3. If an emergency medication is administered to a student, 911 shall be called and the parent/guardian shall be notified.

**5. Naloxone
Naloxone shall only be administered in accordance with Utah Code, 26- 55-101 et seq.
If naloxone is administered to a student, 911 shall be called and the parent/guardian shall be notified.

Essential Oils

1. Essential Oils may be used as an alternative treatment for headache or other clearly identified use.  Parents are requested to provide written permission to accompany oils used by elementary students.  Secondary students may use oil at their own discretion.
2. Oil must be in original container.
3. Oil should not be shared among students.

When To Call 911

Certain Medical conditions requiring immediate emergency medical response include:

1. Unconscious-unresponsive to stimuli
2. Anaphylaxis – severe allergic reaction requiring use of Epi Pen.  Paramedics MUST be called whenever a student is required to use an Epi Pen.
3. Stroke – sudden slurred speech, blindness., numbness, lack of feeling on one side, or lack of coordination.
4. Bleeding- uncontrolled bleeding, including uncontrolled nose bleeds, vomiting blood.
5. Shock- rapid or shallow breathing, cold or clammy skin.
6. Broken bones visible through an open wound.  A finger or other extremity is cut off.
7. Severe cuts- including eye, head and abdominal, or whenever bleeding cannot be safely stopped.
8. Possible overdose – when stocked Narcan is administered
9. Seizure Rescue Medication is administered
10. Diabetic patient is unconscious or difficult to rouse.
11. Severe asthma attack.

References:

Utah Code, 26-41-101
Utah Code 26-55-101
Utah Code 53G-9-502
Utah Code 53G-9-503
Utah Code 53G-9-504
Utah Code 53G-9-505
Utah Admin. Code, R156-31b