ADMINISTRATIVE RULE 453.4

AR453.4   -   Administration of Medication to Students

Medications should be administered at home whenever possible. If it is necessary for a student to take any medication (prescription/non-prescription), this shall be done in accordance with district guidelines. 

A.    Definitions:

1.    Prescription Medications - Those medications, which are obtainable only with the written consent of a licensed physician or other health care practitioner.

2.    Non-prescription Medications - Those which can be obtained over the counter, without a prescription

3.    Prescribing Health Care Practitioner – Licensed physician, dentist, podiatrist, physician’s assistant, optometrist or advanced practice nurse prescriber (APNP) in the State of Wisconsin.

4.    Controlled Substances – Those drugs that are defined and regulated by the Uniform Controlled Substances Act (Section 290, Code of Federal Regulations/Controlled Substances).

5.    Administering Medication to Students form – District form completed with the following information:

a. Student name, date of birth

b. Medication name, dose, route, frequency, time/conditions, duration

c. Reason for medication

d. Listing of possible side effects and/or special instructions

e. Name of prescribing health care practitioner

f. Parent/guardian signature, prescribing health care practitioner signature*, date

*Prescribing health care practitioner signature required for prescription medications, non-FDA approved medications and non-prescription medications that exceed the manufacturers recommended dosage.

B.    Training, Supervision, and Evaluation

Students requiring medication at school shall be identified and reported to the building administrator/designee by the parent/guardian. The School Nurse shall designate school personnel to administer medications. The building administrator will complete a “Staff Authorization to Administer Medication” form. for each designee. This form shall be completed on an annual basis.

The School Nurse shall provide training, supervision, and evaluation to designated school personnel in the administration of medications. This training shall be documented. No school employee, except a health care practitioner, is required to administer a medication to a student by any means other than oral ingestion. In the event that an employee volunteers to administer a medication by other than oral means, the School Nurse will provide the appropriate DPI approved training, in compliance with the written instruction of the prescribing health care practitioner, and with the written consent of the parent(s)/guardian(s). The School Nurse shall be responsible for periodic review of the written medication instructions, as well as designating appropriate documentation procedures and safe storage of medication in school.

C.    Administration Procedures

The following procedures are established within each building to ensure the consistent administration of medication to students:

1.    Parent(s)/Guardian(s) of students requiring medication at school shall submit an “Administering Medication to Students” form to the school office annually. Parent(s)/Guardian(s) are responsible for:

a. Restocking and safe delivery of the medications to and from school.  It is recommended that medications are not transported to and from school by students.

b. Medications that are kept in the office during the school year need to be picked up one week following the last day of school. Medications that are not picked up by that time will be disposed of properly.

2.    The “Administering Medication to Students” form shall be reviewed initially at the beginning of the year or upon receipt of form by a School Nurse or her/his designee.

3.    The School Nurse will review Student Medication Record each semester. Documentation of this review will be recorded on the Administration Review Log.

4.    The length of period for which the medication is to be administered shall be contained in the written instructions from the prescribing health care practitioner as reported on the “Administering Medications to Students” form. Further written instruction shall be received from the prescribing health care practitioner/parent(s)/guardian(s). If the medication is to be discontinued or if the dosage or time it is to be administered is changed from the original instructions, a new “Administering Medication to Students” form must be submitted. The School Nurse shall be notified of new dosage instruction. The School Nurse will make contact with prescribing health care practitioner.

5.    The building administrator or designee shall complete a Student Medication Record for each student receiving medication. When a medication is administered, the date, time, and signature of the individual shall be recorded on the Student Medication Record and kept with the “Administering Medication to Students” form.

6.    Medication will be offered to the student at the designated times. If the student refuses, the parent(s)/guardian(s) are to be informed as soon as possible and the refusal shall be logged on the Student Medication Record.

7.    Parent(s)/Guardian(s) may administer medications to their own child at any time.  Any employee administering medication to their own child is doing so in the capacity of a parent, not as an employee.

8.    School personnel are to report any unusual behavior of students on medication and such information should be recorded on the Student Medication Record and the School Nurse shall be informed. This record should also include the action taken by the school in response to the student’s unusual reaction to the medication.

9.    It is advisable to have in each school office a list of students receiving medication during school hours, including the type of medication, the dose and time it is to be given. This information is only accessible to staff members authorized to administer medications.

Non-Prescription Medication (FDA approved)

1.    An “Administering Medication to Students” form must be completed by the parent(s)/guardian(s) and be on file at the school authorizing school personnel to administer the medication. This form must be completed annually.

2.    All non-prescription medication shall be in the original labeled container and parent(s)/guardian(s) instructions may not exceed the recommended manufacturer dosage.

3.    School personnel will not administer non-prescription medication to a student that exceeds manufacturer’s recommended dose unless the “Administering Medication to Students” form is signed by the prescribing health care practitioner.

Prescription Medication

1.    A completed “Administering Medication to Students” form must be completed by the parent(s)/guardian(s) and be on file at the school authorizing school personnel to administer. This form must be signed by the prescribing health care provider and completed annually.

2.    Medication must be supplied in the original labeled container to the building administrator or designee. The label on the container shall include the name and telephone number of the pharmacy, student’s name, name of the prescribing health care practitioner, name of the drug and the dosage to be given.

3.    Students taking medication shall be supervised by the building administrator or designee and shall conform to the schedule as prescribed by the prescribing health care practitioner.

Miscellaneous Medication

1.    Non-FDA approved drugs such as herbal medication, dietary supplements, and other products will not be administered at school without an Administering Medication to Students form from a prescribing health care practitioner and parent(s)/guardian(s).

2.    “Pre-procedural” medication, controlled substance medication or “as needed” behavioral medication are not regularly administered by school personnel but may be determined on a case-by-case basis in consultation with a School Nurse and through completion of Administering Medication to Students form.

Student Self-Administration of Medications

1.    Students in grades EC-12

a.    May not self-administer or carry any prescription medications including any controlled medications regulated by the Uniform Controlled Substances Act (Section 290.1, Code of Federal Regulation/Controlled Substances).

b.    Exceptions to self-administration of prescription medications are defined below (c.) as emergency medications and any prescription self-administration medication defined in an Individual Health Plan that is completed and authorized by the prescribing health care practitioner, parent(s)/guardian(s) and school nurse.

c.     Students in grades EC-12 who need to carry and self-administer certain emergency medication, such as, epi-pen, asthma inhaler, insulin, glucagon:

                                       i.     Special permission will be granted with parent(s)/guardian(s) and prescribing health care practitioner authorization on the “Administering Medication to Students” form.

2.    Students in grades EC-5

a.    May not self-administer oral prescription or non-prescription medications while at school.

b.    Medications are required to be kept in a locked area in the school office.

c.     Medications are to be administered by those designated/trained school personnel.

3.    Students in grades 6-12

a.    May self-administer oral non-prescription medications while at school. In such cases an “Administering Medication to Students” form shall be completed by the parent(s)/guardian(s).

b.    The individual student may keep such medications in their locked locker however, it is highly encouraged for medications to be kept locked in the office.

c.     Students self-administering non-prescription medications may not provide these non-prescriptive medications to other students.

Administration of Medication at School-Sponsored Events, Activities and Field Trips

1.    Medication administration will follow the same procedures as medication administered at student’s designated school.

2.    It is required that an “Administering Medication to Students” form be completed  if not already on file.

3.    NO medications will be administered without proper documentation.

4.    Medication will be sent in the original labeled container. Medication may be administered from a district-approved Field Trip envelope as prepared by a School Nurse or her/his designee.

5.    Medication will only be administered by school staff.

Medication Errors

1.    A medication error is defined as failure to administer the prescribed medication:

a.    Within the 30 minutes prior or 30 minutes after the prescribed administration time

b.    Dosage

c.     In accordance with accepted practice

d.    To the correct student

2.    In the event of a medication error of commission or omission, the person who administered the medication should immediately

a.    Notify the School Nurse/School Administrator

b.    Notify the student’s parent(s)/guardian(s)

c.     Complete a “Medication Administration Incident Report” form.

d.    Document the specific error on the back side of the Student Medication Record form.

Legal Ref:         Section 118.29 (2), 441.16, 146.81, Wisconsin Statutes

                        Section 290.1, Code of Federal Regulation/Controlled Substances

                        PI 8.01(2)(g), Wisconsin Administrative Code

Cross Ref.:       Board Policy 453.4 - Administration of Medication to Students